title: Early assessment of acute coronary syndromes in the emergency department: the potential diagnostic value of circulating microRNAs.
abstract: Previous studies investigating the role of circulating microRNAs in acute coronary syndrome (ACS) were based on small patient numbers, performed no comparison with established markers of cardiac injury and did not have appropriate controls. We determined the potential diagnostic value of circulating microRNAs as novel early biomarkers in 332 suspected ACS patients on presentation to the emergency department (ED) in a prospective single-centre study including cardiac miRNAs (miR-1, -208a and -499), miR-21 and miR-146a. Levels of all miRs studied were significantly increased in 106 patients diagnosed with ACS, even in patients with initially negative high-sensitive (hs) troponin or symptom onset <3 h. MiR-1, miR-499 and miR-21 significantly increased the diagnostic value in all suspected ACS patients when added to hs-troponin T (AUC 0.90). These three miRs were strong predictors of ACS independent of clinical co-variates including patient history and cardiovascular risk factors. Interestingly, the combination of these three miRs resulted in a significantly higher AUC of 0.94 than hs-troponin T (0.89). Circulating microRNAs hold great potential as novel early biomarkers for the management of suspected ACS patients.
authors.affiliation: Department of Cardiology, University Medical Center Utrecht, The Netherlands.
authors.forename: Martinus I F J
authors.initials: MI
authors.lastname: Oerlemans
authors.forename: Arend
authors.initials: A
authors.lastname: Mosterd
authors.forename: Marieke S
authors.initials: MS
authors.lastname: Dekker
authors.forename: Evelyn A
authors.initials: EA
authors.lastname: de Vrey
authors.forename: Alain
authors.initials: A
authors.lastname: van Mil
authors.forename: Gerard
authors.initials: G
authors.lastname: Pasterkamp
authors.forename: Pieter A
authors.initials: PA
authors.lastname: Doevendans
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.forename: Joost P G
authors.initials: JP
authors.lastname: Sluijter
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D035683:MicroRNAs / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D014336:Troponin / Q000097:blood
chemical_list: D015415:Biomarkers; D035683:MicroRNAs; D014336:Troponin