Circular RNA in blood samples can predict outcome after myocardial infarction
Researchers from LIH’s Cardiovascular Research Unit and international collaborators published an article in the number one cardiology journal, Journal of the American College of Cardiology, in September 2016. They identified a circular RNA that can predict patient outcome after heart attack and could serve as a biomarker to prevent heart failure.
Medicine has greatly improved survival of patients suffering an acute myocardial infarction, but it still has not been able to decrease the subsequent damage to the heart muscle. 15 to 20% of the patients develop a life threatening condition a few months after the heart attack, a so-called left ventricular dysfunction. The left ventricle is the heart’s main pumping chamber and, if damaged, the patients can develop heart failure, as the heart is not able anymore to pump blood adequately to meet the body’s needs. About 60% of those patients die within 5 years after the heart attack.
Existing tools to detect patients at risk of developing left ventricular dysfunction have serious limitations, making the discovery of novel prognostic biomarkers essential. The study led by LIH’s Cardiovascular Research Unit focused on finding candidate non-coding RNA molecules to be used as biomarkers. The researchers unveiled a novel circular RNA, called MICRA (Myocardial Infarction-associated Circular RNA), as predictor of left ventricular dysfunction after myocardial infarction using blood samples from 409 patients of the national registry of patients with myocardial infarction. Patients with low levels of MICRA in their blood were found to be at high risk to develop the life threatening dysfunction.
The discovery was validated in an independent group of 233 heart attack patients from the German LIFE-Leipzig study by collaborators from the Faculty of Medicine at the University of Leipzig, Germany. In addition, the Institute of Cardiology in Warsaw, Poland, verified that the levels of MICRA in the left ventricle of patients with end-stage heart failure indicate whether this circular RNA plays a role in development of left ventricular dysfunction.
The use of RNAs as biomarkers for various diseases is an active topic of investigation. While it has been suggested that different types of RNA have potential for this purpose, this is the first study showing that circular RNAs can be used as cardiac biomarkers. Although further studies are necessary to confirm the use of MICRA as prognostic biomarker, these findings are highly relevant in the context of personalised medicine, helping doctors tailor diagnosis and treatment to the individual patient. ‘MICRA is a very promising biomarker candidate due to its stability in the blood’, outlines Dr Yvan Devaux, Deputy Head of the Cardiovascular Research Unit. ‘In parallel to developing a prognostic test that can be used in the clinic, investigating the role and regulation of circular RNAs in cardiovascular disease may reveal further fields of application’, he states.
Dr Yvan Devaux, Deputy Head of the Cardiovascular Research Unit, presented the exciting results of the publication at the European Society of Cardiology Congress in Rome in late August, where it was also featured at the Basic Science Highlights session at the end of the event.
The research groups involved in the study are part of a larger network named Cardiolinc™, initiated a few years ago by Dr Devaux. Cardiolinc™ serves as an important exchange platform on the role of non-coding RNAs in cardiovascular disease. The network is currently composed of more than 40 partners from 14 different countries.
Myocardial Infarction-associated Circular RNA Predicting Left Ventricular Dysfunction, Melanie Vausort et al., J Am Coll Cardiol. 68(11):1247-8, 2016.
Dr Devaux’s presentation at the European Society of Cardiology Congress 2016