title: Diagnostic potential of circulating miR-499-5p in elderly patients with acute non ST-elevation myocardial infarction.
abstract: BACKGROUND
  Geriatric patients with acute non-ST elevation myocardial infarction (NSTEMI) can frequently present atypical symptoms and non-diagnostic electrocardiogram. The detection of modest cardiac troponin T (cTnT) elevation is challenging for physicians needing to routinely triage these patients. Unfortunately, non-coronary diseases, such as acute heart failure (CHF), may cause cTnT elevation. Circulating microRNAs (miRs) have emerged as biomarkers of MI. However, their diagnostic potential needs to be determined in elderly NSTEMI patients.
  
  
  METHODS
  92 NSTEMI patients (82.6 ± 6.9 years old; complicated by CHF in 74% of cases) and 81 patients with acute CHF without AMI (81.3 ± 6.8 years old) were enrolled at presentation. A third group comprised 99 age-matched healthy control subjects (CTR). Plasma levels of miR-1, -21, -133a, -208a, -423-5p and -499-5p were analyzed.
  
  
  RESULTS
  MiR-1, -21 -133a and -423-5p showed a 3- to 10-fold increase and miR-499-5p exhibited >80-fold increase in acute NSTEMI patient vs. CTR. MiR-499-5p and -21 showed a significantly increased expression in NSTEMI vs. CHF. Interestingly, mir-499-5p was comparable to cTnT in discriminating NSTEMI vs. CTR and CHF patients. Its diagnostic accuracy was higher than conventional and hs-cTnT in differentiating NSTEMI (n=31) vs. acute CHF (n=32) patients with modest cTnT elevation at presentation (miR-499-5p AUC=0.86 vs. cTnT AUC=0.68 and vs. hs-cTnT AUC=0.70).
  
  
  CONCLUSIONS
  Circulating miR-499-5p is a sensitive biomarker of acute NSTEMI in the elderly, exhibiting a diagnostic accuracy superior to that of cTnT in patients with modest elevation at presentation.
authors.affiliation: Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, Ancona, Italy. f.olivieri@univpm.it
authors.forename: Fabiola
authors.initials: F
authors.lastname: Olivieri
authors.forename: Roberto
authors.initials: R
authors.lastname: Antonicelli
authors.forename: Maria
authors.initials: M
authors.lastname: Lorenzi
authors.forename: Yuri
authors.initials: Y
authors.lastname: D'Alessandra
authors.forename: Raffaella
authors.initials: R
authors.lastname: Lazzarini
authors.forename: Gabriele
authors.initials: G
authors.lastname: Santini
authors.forename: Liana
authors.initials: L
authors.lastname: Spazzafumo
authors.forename: Rosamaria
authors.initials: R
authors.lastname: Lisa
authors.forename: Lucia
authors.initials: L
authors.lastname: La Sala
authors.forename: Roberta
authors.initials: R
authors.lastname: Galeazzi
authors.forename: Rina
authors.initials: R
authors.lastname: Recchioni
authors.forename: Roberto
authors.initials: R
authors.lastname: Testa
authors.forename: Giulio
authors.initials: G
authors.lastname: Pompilio
authors.forename: Maurizio C
authors.initials: MC
authors.lastname: Capogrossi
authors.forename: Antonio Domenico
authors.initials: AD
authors.lastname: Procopio
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D035683:MicroRNAs / Q000097:blood*; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis*; D012189:Retrospective Studies
chemical_list: D015415:Biomarkers; C548683:MIRN499 microRNA, human; D035683:MicroRNAs