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Serially measured circulating miR-22-3p is a biomarker for adverse clinical outcome in patients with chronic heart failure: The Bio-SHiFT study

医学 心力衰竭 内科学 心脏病学 生物标志物 临床终点 比例危险模型 心脏移植 前瞻性队列研究 队列 肌钙蛋白 队列研究 临床试验 心肌梗塞 生物化学 化学
作者
Nick van Boven,K. Martijn Akkerhuis,Sharda S. Anroedh,Dimitris Rizopoulos,Yigal M. Pinto,Linda C. Battes,Hans L. Hillege,Kadir Çalışkan,Tjeerd Germans,Olivier C. Manintveld,Jan H. Cornel,Alina A. Constantinescu,Eric Boersma,Victor Umans,Isabella Kardys
出处
期刊:International Journal of Cardiology [Elsevier]
卷期号:235: 124-132 被引量:35
标识
DOI:10.1016/j.ijcard.2017.02.078
摘要

Several studies have suggested circulating microRNAs (miRs) are associated with heart failure, but these studies were small, and limited to single miR measurements. We examined 7 miRs which were previously linked to heart failure, and tested whether their temporal expression level predicts prognosis in a prospective cohort of chronic heart failure (CHF) patients.In 2011-2013, 263 CHF patients were included. At inclusion and subsequently every 3months, we measured 7miRs. The primary endpoint (PE) comprised heart failure hospitalization, cardiovascular mortality, cardiac transplantation and LVAD implantation. Associations between temporal miR patterns and the PE were investigated by joint modelling, which combines mixed models with Cox regression. Mean age was 67±13years, 72% were men and 27% NYHA classes III-IV. We obtained 873 blood samples (median 3 [IQR 2-5] per patient). The PE was reached in 41 patients (16%) during a median follow-up of 0.9 [0.6-1.4] years. The temporal pattern of miR-22-3p was independently associated with the PE (HR [95% CI] per doubling of level: 0.64 [0.47-0.77]). The instantaneous change in level (slope of the temporal miR pattern) of miR-22-3p was also independently associated with the PE (HR [95% CI] per doubling of slope: 0.33 [0.20-0.51]). These associations remained statistically significant after adjustment for temporal patterns of NT-proBNP, Troponin T and CRP.The temporal pattern of circulating miR-22-3p contains important prognostic and independent information in CHF patients. This concept warrants further investigation in larger series with extended follow-up.
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