Evaluation of miR-21 and miR-23 expression level in blood samples of patients with AHF and their relationship with patients’ outcome

Abstract

Heart failure is one of the most prevalent cardiac disorders which causes extensive mortality and morbidity. A lot of studies have been performed for finding novel biomarkers to improve diagnostic acuity for this disease. Recently a variety of miRNAs including miRNA-21 and -23 have been suggested for diagnosis of this disease; however, it has not established yet. Also, the relationship between these miRNAs and the prognosis of these patients has not been studied so far. Therefore, the aim of this study is to evaluate the role of miRNA-21 and -23 in diagnosis and their relationship with prognosis of patients with acute heart failure. Methods & Materials: This case-control study was conducted on 102 blood plasma samples obtained from patients admitted with a diagnosis of acute heart failure in Tabriz Shahid Madani hospital and healthy control group. Then the samples were evaluated regarding miR-21 and miR-23 by means of real-time PCR technique. One year later than patients’ discharge, some of the prognostic related factors including one-year mortality, in-hospital mortality, number of readmissions, and function class were assessed. The collected data was analyzed using descriptive and inferential statistics by SPSS version 22.

Results: An overall 102 blood plasma samples were obtained from 44 patients with heart failure (43.5%) and 58 controls (57.5%). There was no significant difference in demographic characteristics between the two groups (p> 0.05). Mean miRNA-21 in patients with heart failure was 1.445 +/- 0.534 which was significantly higher than the control group (p value=0.002). The sensitivity and specificity of miR-21 higher than 1 were 79.5% and 100%, respectively (AUC=0.807, p=0.001). MiR-21 was significantly higher in heart failure patients due to ischemic causes as compared to non-ischemic causes (p=0.008). Mean miRNA-23 was 1.490 +/- 0.545; which was significantly higher than the control group (p value=0.002). The sensitivity and specificity of miR-23 higher than 1 were 86.4% and 100%, respectively (AUC=0.874, p=0.001). MiR-23 was significantly higher in heart failure patients due to ischemic causes as compared to non-ischemic causes (p=0.029). Data analysis in patients' follow up, demonstrated that miR-21 and miR-23 in patients' primary admission had no significant relationship with prognostic variables including one-year mortality, in-hospital mortality, number of readmissions, and function class (p>0.05 for all variables).