Utility of miRNA biomarkers in patients with acute myocardial infarction (UNIAMI)-results from a prospective pilot study.

BACKGROUND

Acute myocardial infarction (AMI) is a leading cause of death worldwide, occurring earlier and more severely in South Asian populations. Circulating microRNAs (miRNAs) are stable, non-invasive biomarkers with emerging diagnostic and prognostic potential, but population-specific data from South India remain limited.

METHODS

In this prospective cohort, 216 participants were enrolled: 45 AMI patients, 71 stable coronary artery disease (CAD) patients, and 100 healthy controls. Plasma samples were collected within 24 h of symptom onset in AMI cases. Expression of prioritized circulating miRNAs (n = 20) was quantified using qRT-PCR SYBR green chemistry using specific primers. Statistical analyses included hierarchical and k-means clustering, principal component analysis (PCA), pathway enrichment, and receiver operating characteristic (ROC) curve analyses.

RESULTS AND

CONCLUSION

MI patients showed significant upregulation of let-7b, let-7c-5p, miR-24-1, miR-342-3p, and miR-362-3p, and downregulation of miR-4485-3p, miR-494-3p, miR-939, and miR-4505 (p < 0.05). Cluster and PCA analyses revealed distinct segregation of AMI cases, while CAD exhibited intermediate molecular profiles. Pathway enrichment implicated ECM-receptor interaction, platelet activation, and PI3K/AKT signaling. ROC analysis demonstrated excellent discriminatory performance, with miR-4485-3p achieving an AUC of 1.000. There were no significant differences in the expression pattern of miR-3195, miR-6780b-5p between CAD and AMI patients. These findings highlight circulating miRNAs as promising biomarkers for AMI, reflecting key molecular processes of inflammation, apoptosis, and endothelial dysfunction.