Long Non-Coding RNAs in Patients With Acute Myocardial Infarction
Rationale:Long non-coding RNAs (lncRNAs) constitute a novel class of non-coding RNAs that regulate gene expression. Although recent data suggest that lncRNAs may be associated with cardiac disease, little is known about lncRNAs in the setting of myocardial ischemia.
Objective: To measure lncRNAs in patients with myocardial infarction (MI).
Methods and Results: We enrolled 414 patients with acute MI treated by primary percutaneous coronary intervention. Blood samples were harvested at the time of reperfusion. Expression levels of 5 lncRNAs were measured in peripheral blood cells by quantitative PCR: aHIF, ANRIL, KCNQ1OT1, MIAT and MALAT1. Levels of aHIF, KCNQ1OT1 and MALAT1 were higher in MI patients than healthy volunteers (P<0.01), and levels of ANRIL were lower in MI patients (P=0.003). Patients with ST-elevation myocardial infarction (STEMI) had lower levels of ANRIL (P<0.001), KCNQ1OT1 (P<0.001), MIAT (P<0.001) and MALAT1 (P=0.005) compared to patients with non-STEMI. Levels of ANRIL were associated with age, diabetes and hypertension. Patients presenting within 3h of chest pain onset had elevated levels of aHIF as compared to patients presenting later on. ANRIL, KCNQ1OT1, MIAT and MALAT1 were significant univariable predictors of left ventricular dysfunction as assessed by an ejection fraction ≤40% at 4-month follow-up. In multivariable and reclassification analyses, ANRIL and KCNQ1OT1 improved the prediction of left ventricular dysfunction by a model including demographic features, clinical parameters and cardiac biomarkers.
Conclusions: Levels of lncRNAs in blood cells are regulated after MI and may help in prediction of outcome. This motivates further investigation of the role of lncRNAs after MI.
- Received March 19, 2014.
- Revision received July 14, 2014.
- Accepted July 16, 2014.