Circulating microRNAs as potential biomarkers for the early diagnosis of acute myocardial infarction: Promises and challenges

摘要

We read with great interest the letter of Lippi et al., who recently performed a meta-analysis of different circulating microRNAs (miRs), e.g. miR-1, -133, -208, -499 and -663b, describing their sensitivity and specificity in diagnosis of acute myocardial infarction (AMI). In fact, the increased cell-free miRs may not only be a product of plasma membrane disruption following cell death, but also a consequence of an active release from living cells exposed to ischemic condition, thereby it can be hypothesized that circulating cardiac miRs may be earlier biomarkers of myocardial necrosis.A rapid and efficient assessment of AMI is essential because of the reduced mortality rate and prognostic benefit following timely interventions. Nevertheless, early diagnostic evaluation of patients suspected of having AMI remains a challenge, especially when electrocardiogram (ECG) is nondiagnostic. Currently, definitive diagnosis of AMI is mainly based on the elevated biomarkers of damaged cardiomyocytes, cardiac troponin T and I (cTnT and cTnl) or creatinine kinase-MB isoenzyme (CK-MB) if cTn is unavailable, in the context of clinical and ECG findings.