title: Use of circulating microRNAs to diagnose acute myocardial infarction.
abstract: BACKGROUND
  Rapid and correct diagnosis of acute myocardial infarction (MI) has an important impact on patient treatment and prognosis. We compared the diagnostic performance of high-sensitivity cardiac troponin T (hs-cTnT) and cardiac enriched microRNAs (miRNAs) in patients with MI.
  
  
  METHODS
  Circulating concentrations of cardiac-enriched miR-208b and miR-499 were measured by quantitative PCR in a case-control study of 510 MI patients referred for primary mechanical reperfusion and 87 healthy controls.
  
  
  RESULTS
  miRNA-208b and miR-499 were highly increased in MI patients (>10(5)-fold, P < 0.001) and nearly undetectable in healthy controls. Patients with ST-elevation MI (n= 397) had higher miRNA concentrations than patients with non-ST-elevation MI (n = 113) (P < 0.001). Both miRNAs correlated with peak concentrations of creatine kinase and cTnT (P < 10(-9)). miRNAs and hs-cTnT were already detectable in the plasma 1 h after onset of chest pain. In patients who presented <3 h after onset of pain, miR-499 was positive in 93% of patients and hs-cTnT in 88% of patients (P= 0.78). Overall, miR-499 and hs-cTnT provided comparable diagnostic value with areas under the ROC curves of 0.97. The reclassification index of miR-499 to a clinical model including several risk factors and hs-cTnT was not significant (P = 0.15).
  
  
  CONCLUSIONS
  Circulating miRNAs are powerful markers of acute MI. Their usefulness in the establishment of a rapid and accurate diagnosis of acute MI remains to be determined in unselected populations of patients with acute chest pain.
authors.affiliation: Laboratory of Cardiovascular Research, Centre de Recherche Public, Santé, Luxembourg.
authors.forename: Yvan
authors.initials: Y
authors.lastname: Devaux
authors.forename: Mélanie
authors.initials: M
authors.lastname: Vausort
authors.forename: Emeline
authors.initials: E
authors.lastname: Goretti
authors.forename: Petr V
authors.initials: PV
authors.lastname: Nazarov
authors.forename: Francisco
authors.initials: F
authors.lastname: Azuaje
authors.forename: Georges
authors.initials: G
authors.lastname: Gilson
authors.forename: Maarten F
authors.initials: MF
authors.lastname: Corsten
authors.forename: Blanche
authors.initials: B
authors.lastname: Schroen
authors.forename: Marie-Lise
authors.initials: ML
authors.lastname: Lair
authors.forename: Stephane
authors.initials: S
authors.lastname: Heymans
authors.forename: Daniel R
authors.initials: DR
authors.lastname: Wagner
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D035683:MicroRNAs / Q000097:blood* / Q000235:genetics; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis*; D020411:Oligonucleotide Array Sequence Analysis; D012680:Sensitivity and Specificity
chemical_list: D035683:MicroRNAs