Expression of microRNA-133a and microRNA-208b in acute myocardial infarction; A randomized clinical trial

Abstract Background: Myocardial microRNAs (Myo-miR) like MiR-1, miR-133 and miR-208 are specific to cardiac muscles development and function. Diagnostic potential of MiR-1, miR-133 and miR-208 in acute episodes of myocardial infarction is unknown. Methods: Patient of newly onset of acute myocardial infarction with elevated ST-segment admitted to Ain-Shams university hospital Cairo from May 2013 to December 2022 were enrolled. Written consent was obtained. Circulating MiRNAs were measured at 04, 08, 12, 24, 48 hours from onset of angina by RT-PCR and compare with conventional creatin-kinases for diagnostic potential. Results were analyzed by student t-test, ROC curve calculations and ANOVA were performed using GraphPad-Prism-9Version. Results: 746 patients admitted with STEMI and 10(1.34%) cases were presented with new-onset episodes of STEMI with mean±SD age 54.2±8.49 year. miR-133a peaks at 8 hours, miR-208b peaks at 12 hours from onset of AMI compared to cTnI and CK-MB peak at 12hrs(P<0.001). ROC-curve for miR-133a AUC was 0.583,0.8,1,0.78 and 0.58 at 4,8,12,24 & 48 hours respectively. AUC for miR-208b was 0.87,0.888,0.888,0.627 compared to AUC of cTnI concentrations 0.59,1,1,0.75,0 and (ROC) curve for CK-MB was 0.59,1,1,0.8&0.73 respectively. Positive correlation was present between miR-133a and cTnI (R=0.926-R2= 0.858 P=0.47), miR-208b and cTnI (R=0.8-R2=0.64 P=0.1) , miR-208b and CK-MB was (R=0.888-R2=0.789 P=0.044) and CK-MB-cTnI (R=0.72) respectively. Conclusion: We showed miR-133a and miR-208b diagnostic specificity superior over conventional blood biomarkers for acute onset of STEMI. (NCT05692752)