title: Relation of circulating MicroRNA-133a concentrations with myocardial damage and clinical prognosis in ST-elevation myocardial infarction.
abstract: BACKGROUND
  Circulating microRNAs (miRs) have emerged as potential diagnostic markers in patients with myocardial infarction. Previous studies, however, were based on limited patient numbers and could not assess the relation of miRs to myocardial damage. Moreover, the prognostic value of miRs in ST-elevation myocardial infarction (STEMI) is unknown. The aims of this study were (1) to assess the relation between miR-133a and myocardial damage assessed by cardiovascular magnetic resonance (CMR) imaging and (2) to evaluate the prognostic value of miR-133a in reperfused STEMI.
  
  
  METHODS
  MicroRNA-133a concentrations were determined in 216 consecutive patients with STEMI undergoing primary angioplasty less than 12 hours after symptom onset. Patients were categorized into 2 groups defined by the median miR-133a value on admission. Cardiovascular magnetic resonance was performed for assessment of infarct size, myocardial salvage, and microvascular obstruction. The primary clinical end point was the occurrence of major adverse cardiovascular events defined as a composite of death, reinfarction, and new congestive heart failure within 6 months after infarction.
  
  
  RESULTS
  All prognostic relevant CMR markers (infarct size, microvascular obstruction, myocardial salvage index) showed significant correlations with circulating miR-133a concentrations (P < .001 for all).The strongest predictors of miR-133a concentrations were the time from symptom onset to reperfusion and the amount of the salvaged area at risk. Major adverse cardiovascular events occurred significantly more often in the miR-133a ≥ median group (9% vs 20%, P = .025). However, miR-133a concentrations were unable to independently predict clinical events.
  
  
  CONCLUSIONS
  Elevated levels of circulating miR-133a in patients with STEMI are associated with decreased myocardial salvage, larger infarcts, and more pronounced reperfusion injury. Consequently, miR-133a concentrations can provide prognostic information but do not add independent prognostic information to traditional and CMR markers of clinical prognosis in a high-risk STEMI population.
authors.affiliation: Department of Internal Medicine/Cardiology, University of Leipzig-Heart Center, Leipzig, Germany. ingoeitel@gmx.de
authors.forename: Ingo
authors.initials: I
authors.lastname: Eitel
authors.forename: Volker
authors.initials: V
authors.lastname: Adams
authors.forename: Patrick
authors.initials: P
authors.lastname: Dieterich
authors.forename: Georg
authors.initials: G
authors.lastname: Fuernau
authors.forename: Suzanne
authors.initials: S
authors.lastname: de Waha
authors.forename: Steffen
authors.initials: S
authors.lastname: Desch
authors.forename: Gerhard
authors.initials: G
authors.lastname: Schuler
authors.forename: Holger
authors.initials: H
authors.lastname: Thiele
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D008297:Male; D035683:MicroRNAs / Q000097:blood*; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction
chemical_list: D015415:Biomarkers; C548234:MIRN133 microRNA, human; D035683:MicroRNAs