Background

Acute Coronary Syndrome (ACS) stands as a significant contributor to cardiovascular mortality, necessitating improved diagnostic tools for early detection and tailored therapeutic interventions. Current diagnostic modalities, exhibit limitations in sensitivity and specificity, urging the quest for novel biomarkers to enhance discrimination of the different stages of ACS including unstable angina, Non-ST-segment Elevation Myocardial Infarction (NSTEMI), and ST-segment Elevation Myocardial Infarction (STEMI).

Methods

This study investigated the potential of a plasma-circulating multi-noncoding RNA (ncRNA) panel, comprising four miRNAs (miR-182–5p, miR-23a-3p, miR-146a-5p, and miR-183–5p) and three lncRNAs (SNHG15, SNHG5, and RMRP), selected based on their intricate involvement in ACS pathogenesis and signaling pathways regulating post-myocardial infarction (MI) processes. The differential expression of these ncRNAs was validated in sera of ACS patients and healthy controls via real-time polymerase chain reaction (RT-PCR).

Results

Analysis revealed a marked upregulation of the multi-ncRNAs panel in ACS patients. Notably, miRNA-182–5p and lncRNA-RMRP exhibited exceptional discriminatory power, indicated by the high area under the curve (AUC) values (0.990 and 0.980, respectively). Importantly, this panel displayed superior efficacy in discriminating between STEMI and NSTEMI, outperforming conventional biomarkers like creatine kinase-MB and cardiac troponins. Additionally, the four miRNAs and lncRNA RMRP showcased remarkable proficiency in distinguishing between STEMI and unstable angina.

Conclusion

The findings underscore the promising potential of the multi-ncRNA panel as a robust tool for early ACS detection, and precise differentiation among ACS subtypes, and as a potential therapeutic target.

中文翻译：

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循环多非编码 RNA 组在急性冠状动脉综合征亚型中的区分能力：迈向精确检测

背景

急性冠状动脉综合征 (ACS) 是导致心血管死亡的一个重要因素，因此需要改进诊断工具以进行早期检测和量身定制的治疗干预措施。目前的诊断方式在敏感性和特异性方面存在局限性，迫切需要寻找新的生物标志物来增强对 ACS 不同阶段的区分，包括不稳定型心绞痛、非 ST 段抬高型心肌梗死 (NSTEMI) 和 ST 段抬高型心肌梗死 ( STEMI）。

方法

本研究调查了血浆循环多非编码 RNA (ncRNA) 组的潜力，该组包含四种miRNA （miR-182–5p、miR-23a-3p、miR-146a-5p 和 miR-183–5p）和三种lncRNA（SNHG15、SNHG5 和 RMRP）的选择是基于它们在 ACS 发病机制和调节心肌梗死后 (MI) 过程的信号通路通过实时聚合酶链式反应 (RT-PCR)，在 ACS 患者和健康对照的血清中验证了这些 ncRNA 的差异表达。

结果

分析显示 ACS 患者的多 ncRNA 组显着上调。值得注意的是，miRNA-182–5p 和 lncRNA-RMRP 表现出非凡的辨别力，高曲线下面积 (AUC) 值（分别为 0.990 和 0.980）表明了这一点。重要的是，该小组在区分 STEMI 和 NSTEMI 方面表现出卓越的功效，优于肌酸激酶 MB 和心肌肌钙蛋白等传统生物标志物。此外，四种 miRNA 和 lncRNA RMRP 在区分 STEMI 和不稳定心绞痛方面表现出卓越的能力。

结论

这些发现强调了多 ncRNA 组合作为早期 ACS 检测、精确区分 ACS 亚型的强大工具以及作为潜在治疗靶点的巨大潜力。