Circulating MicroRNA-499 as a Diagnostic Biomarker for Acute Myocardial Infarction: A Meta-analysis

BACKGROUND: Recent studies have shown that circulating microRNA-499 could be a powerful biomarker of acute myocardial infarction (AMI). Interest in circulating microRNA-499 for detecting AMI is increasing rapidly. To evaluate the diagnosis of circulating microRNA-499 for AMI, this study was performed. METHODS: We searched PubMed, Embase, and the Cochrane Library for studies published up to December 31, 2018, as well as the reference lists of relevant studies. Studies were included if they assessed the accuracy of blood circulating microRNA-499 or cardiac troponin T (cTnT) for AMI and provided sufficient data to construct a 2 × 2 contingency table. Extracted data were analysed for sensitivity, specificity, diagnostic odds ratio (DOR), and summary receiver operator curve (SROC) analyses. Prespecified subgroup analysis and metaregression were also performed. RESULTS: Fourteen studies including 3816 participants were included in this meta-analysis. The overall pooled sensitivity and specificity were 0.84 (95% CI: 0.64-0.94) and 0.97 (95% CI: 0.90-0.99), respectively. The area under the SROC curve (AUC) was 0.98 (95% CI: 0.96-0.99). The studies had substantial heterogeneity (I(2) = 98.74%). Seven studies also used cTnT as a marker for the diagnosis of AMI. The overall pooled sensitivity and specificity of cTnT were 0.95 (95% CI: 0.87-0.98) and 0.96 (95% CI: 0.85-0.99), respectively. The area under the SROC curve (AUC) was 0.99 (95% CI: 0.97-0.99). The DOR of circulating miR-499 and cTnT were 188 (95% CI: 19-1815) and 420 (95% CI: 86-2038), respectively. Metaregression analysis suggested that specimen and healthy controls were the main sources of heterogeneity. No publication bias was suggested by Deeks' regression test of asymmetrical funnel plot (t = 0.85; p value = 0.41). CONCLUSION: The results showed that circulating microRNA-499 is a reliable biomarker for diagnosing AMI patients.