Combined Use of Circulating miR-133a and NT-proBNP Improves Heart Failure Diagnostic Accuracy in Elderly Patients - PubMed (original) (raw)
Combined Use of Circulating miR-133a and NT-proBNP Improves Heart Failure Diagnostic Accuracy in Elderly Patients
Meizi Guo et al. Med Sci Monit. 2018.
Abstract
BACKGROUND Circulating microRNAs (miRNAs) are emerging as novel biomarkers for detecting cardiovascular diseases. Here, circulating miR-133a and miR-221 were investigated as potential diagnostic biomarkers for heart failure (HF) patients, particularly in elderly patients. MATERIAL AND METHODS A total of 94 elderly HF patients (mean age=77.4 years old) and 31 healthy controls (age- and sex-matched) participated in this study. Plasma NT-proBNP levels were measured using an electrochemiluminescence immunoassay, and circulating miR-133a and miR-221 levels were examined using real-time quantitative PCR, with diagnostic efficacies determined for each independently and in combination. RESULTS MiR-133a expression increased by 4.6-fold (P<0.001) and miR-221 expression increased by 2.0-fold (P<0.001) in the elderly HF patients relative to the healthy controls. ROC curves were generated and AUC values of 0.863 for miR-133a (CI95%: 0.800-0.927), 0.718 for miR-221 (CI95%: 0.622-0.813), and 0.895 for NT-proBNP (CI95%: 0.841-0.948) were obtained. Unlike NT-proBNP, miR-133a and miR-221 were found to be unaffected by age, BMI, renal function, albumin, or Hb levels. More importantly, the diagnostic value of NT-proBNP was found to be improved when combined with any of the examined miRNA biomarkers alone or in a panel. When combining miR-133a with NT-proBNP, an AUC value of 0.975 (CI95%: 0.950-0.999) was obtained, which was significantly higher than for NT-proBNP alone (z=2.395, P=0.016). CONCLUSIONS miR-133a and miR-221 can serve as potential HF diagnostic biomarkers in elderly patients. Moreover, the diagnostic accuracy of NT-proBNP can be improved by the addition of miR-133a.
Conflict of interest statement
Conflicts of interest
None.
Figures
Figure 1
Comparison of miRNAs and NT-proBNP levels in HF patients and healthy controls. Differences between 2 independent groups were analyzed using a Mann-Whitney U test, while differences among multiple independent groups were analyzed using a Kruskal-Wallis test. (A) miR-133a levels in HF patients and healthy controls. (B) miR-133a levels in the NYHA II, NYHA III, NYHA IV, and healthy control groups. (C) miR-221a levels in HF patients and healthy controls. (D) miR-221 levels in the NYHA II, NYHA III, NYHA IV, and healthy control groups. (E) NT-proBNP levels in HF patients and healthy controls. (F) NT-proBNP levels in the NYHA II, NYHA III, NYHA IV, and healthy control groups. ** P<0.01.
Figure 2
Receiver operating characteristic (ROC) analysis. ROC curves were generated for miR-133a (A), miR-221 (B), miR-133a combined with miR-221 (C), NT-proBNP (D), miR-133a combined with NT-proBNP (E), miR-221 combined with NT-proBNP (F), and miR-133a/221 combined with NT-proBNP (G).
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