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Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation

Background. Atrial fibrillation (AF) increases the risk for stroke but also for non-stroke major adverse cardiovascular events (MACE). The 2MACE score was recently proposed to predict these events. Since the interest of microRNAs (miRNAs) in cardiovascular diseases is increasing, we aimed to investi...

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Autores principales: Rivera-Caravaca, José Miguel, Teruel-Montoya, Raúl, Roldán, Vanessa, Cifuentes-Riquelme, Rosa, Crespo-Matas, José Antonio, de los Reyes-García, Ascensión María, Águila, Sonia, Fernández-Pérez, María Piedad, Reguilón-Gallego, Laura, Zapata-Martínez, Laura, García-Barberá, Nuria, Vicente, Vicente, Marín, Francisco, Martínez, Constantino, González-Conejero, Rocío
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698124/
https://www.ncbi.nlm.nih.gov/pubmed/33198388
http://dx.doi.org/10.3390/jcm9113645
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author Rivera-Caravaca, José Miguel
Teruel-Montoya, Raúl
Roldán, Vanessa
Cifuentes-Riquelme, Rosa
Crespo-Matas, José Antonio
de los Reyes-García, Ascensión María
Águila, Sonia
Fernández-Pérez, María Piedad
Reguilón-Gallego, Laura
Zapata-Martínez, Laura
García-Barberá, Nuria
Vicente, Vicente
Marín, Francisco
Martínez, Constantino
González-Conejero, Rocío
author_facet Rivera-Caravaca, José Miguel
Teruel-Montoya, Raúl
Roldán, Vanessa
Cifuentes-Riquelme, Rosa
Crespo-Matas, José Antonio
de los Reyes-García, Ascensión María
Águila, Sonia
Fernández-Pérez, María Piedad
Reguilón-Gallego, Laura
Zapata-Martínez, Laura
García-Barberá, Nuria
Vicente, Vicente
Marín, Francisco
Martínez, Constantino
González-Conejero, Rocío
author_sort Rivera-Caravaca, José Miguel
collection PubMed
description Background. Atrial fibrillation (AF) increases the risk for stroke but also for non-stroke major adverse cardiovascular events (MACE). The 2MACE score was recently proposed to predict these events. Since the interest of microRNAs (miRNAs) in cardiovascular diseases is increasing, we aimed to investigate whether miRNA levels may improve the predictive performance of the 2MACE score. Methods. We included consecutive AF patients stable on vitamin K antagonist therapy. Blood samples were drawn at baseline and plasma expression of miRNAs was assessed. During a median of 7.6 (interquartile range (IQR) 5.4–8.0) years, the occurrence of any MACE (nonfatal myocardial infarction/cardiac revascularization and cardiovascular death) was recorded. Results. We conducted a miRNA expression analysis in plasma from 19 patients with and without cardiovascular events. The miRNAs selected (miR-22-3p, miR-107, and miR-146a-5p) were later measured in 166 patients (47% male, median age 77 (IQR 70–81) years) and all were associated with a higher risk of MACE. The addition of miR-107 and miR-146a-5p to the 2MACE score significantly increased the predictive performance (c-indexes: 0.759 vs. 0.694, p = 0.004), and the model with three miRNAs also improved the predictive performance compared to the original score (c-indexes: 0.762 vs. 0.694, p = 0.012). 2MACE models with the addition of miRNAs presented higher net benefit and potential clinical usefulness. Conclusions. Higher miR-22-3p andmiR-107 and lower miR-146a-5p levels were associated with a higher risk of MACE. The addition of these miRNAs to the 2MACE score significantly increased the predictive performance for MACE, which may aid to some extent in the decision-making process about risk stratification in AF.
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spelling pubmed-76981242020-11-29 Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation Rivera-Caravaca, José Miguel Teruel-Montoya, Raúl Roldán, Vanessa Cifuentes-Riquelme, Rosa Crespo-Matas, José Antonio de los Reyes-García, Ascensión María Águila, Sonia Fernández-Pérez, María Piedad Reguilón-Gallego, Laura Zapata-Martínez, Laura García-Barberá, Nuria Vicente, Vicente Marín, Francisco Martínez, Constantino González-Conejero, Rocío J Clin Med Article Background. Atrial fibrillation (AF) increases the risk for stroke but also for non-stroke major adverse cardiovascular events (MACE). The 2MACE score was recently proposed to predict these events. Since the interest of microRNAs (miRNAs) in cardiovascular diseases is increasing, we aimed to investigate whether miRNA levels may improve the predictive performance of the 2MACE score. Methods. We included consecutive AF patients stable on vitamin K antagonist therapy. Blood samples were drawn at baseline and plasma expression of miRNAs was assessed. During a median of 7.6 (interquartile range (IQR) 5.4–8.0) years, the occurrence of any MACE (nonfatal myocardial infarction/cardiac revascularization and cardiovascular death) was recorded. Results. We conducted a miRNA expression analysis in plasma from 19 patients with and without cardiovascular events. The miRNAs selected (miR-22-3p, miR-107, and miR-146a-5p) were later measured in 166 patients (47% male, median age 77 (IQR 70–81) years) and all were associated with a higher risk of MACE. The addition of miR-107 and miR-146a-5p to the 2MACE score significantly increased the predictive performance (c-indexes: 0.759 vs. 0.694, p = 0.004), and the model with three miRNAs also improved the predictive performance compared to the original score (c-indexes: 0.762 vs. 0.694, p = 0.012). 2MACE models with the addition of miRNAs presented higher net benefit and potential clinical usefulness. Conclusions. Higher miR-22-3p andmiR-107 and lower miR-146a-5p levels were associated with a higher risk of MACE. The addition of these miRNAs to the 2MACE score significantly increased the predictive performance for MACE, which may aid to some extent in the decision-making process about risk stratification in AF. MDPI 2020-11-12 /pmc/articles/PMC7698124/ /pubmed/33198388 http://dx.doi.org/10.3390/jcm9113645 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Rivera-Caravaca, José Miguel
Teruel-Montoya, Raúl
Roldán, Vanessa
Cifuentes-Riquelme, Rosa
Crespo-Matas, José Antonio
de los Reyes-García, Ascensión María
Águila, Sonia
Fernández-Pérez, María Piedad
Reguilón-Gallego, Laura
Zapata-Martínez, Laura
García-Barberá, Nuria
Vicente, Vicente
Marín, Francisco
Martínez, Constantino
González-Conejero, Rocío
Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation
title Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation
title_full Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation
title_fullStr Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation
title_full_unstemmed Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation
title_short Pilot Study on the Role of Circulating miRNAs for the Improvement of the Predictive Ability of the 2MACE Score in Patients with Atrial Fibrillation
title_sort pilot study on the role of circulating mirnas for the improvement of the predictive ability of the 2mace score in patients with atrial fibrillation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7698124/
https://www.ncbi.nlm.nih.gov/pubmed/33198388
http://dx.doi.org/10.3390/jcm9113645
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