Background: Geriatric patients with acute non-ST elevation myocardial infarction (NSTEMI) can frequently present atypical symptoms and non-diagnostic electrocardiogram. The detection of modest cardiac troponin T (cTnT) elevation is challenging for physicians needing to routinely triage these patients. Unfortunately, non-coronary diseases, such as acute heart failure (CHF), may cause cTnT elevation. Circulating microRNAs (miRs) have emerged as biomarkers of MI. However, their diagnostic potential needs to be determined in elderly NSTEMI patients.
Methods: 92 NSTEMI patients (82.6 ± 6.9 years old; complicated by CHF in 74% of cases) and 81 patients with acute CHF without AMI (81.3 ± 6.8 years old) were enrolled at presentation. A third group comprised 99 age-matched healthy control subjects (CTR). Plasma levels of miR-1, -21, -133a, -208a, -423-5p and -499-5p were analyzed.
Results: MiR-1, -21 -133a and -423-5p showed a 3- to 10-fold increase and miR-499-5p exhibited >80-fold increase in acute NSTEMI patient vs. CTR. MiR-499-5p and -21 showed a significantly increased expression in NSTEMI vs. CHF. Interestingly, mir-499-5p was comparable to cTnT in discriminating NSTEMI vs. CTR and CHF patients. Its diagnostic accuracy was higher than conventional and hs-cTnT in differentiating NSTEMI (n=31) vs. acute CHF (n=32) patients with modest cTnT elevation at presentation (miR-499-5p AUC=0.86 vs. cTnT AUC=0.68 and vs. hs-cTnT AUC=0.70).
Conclusions: Circulating miR-499-5p is a sensitive biomarker of acute NSTEMI in the elderly, exhibiting a diagnostic accuracy superior to that of cTnT in patients with modest elevation at presentation.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijcard.2012.01.075 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Prognostic significance of serum complement activation, neutrophil extracellular traps and extracellular DNA in newly diagnosed epithelial ovarian cancer.
Gynecol Oncol
January 2025
Departments of Internal Medicine and Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States of America; Department of Medicine, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, NY, United States of America.
Purpose: We observed that the tumor microenvironment (TME) in metastatic epithelial ovarian cancer (EOC) and in other solid tumors can reprogram normal neutrophils to acquire a complement-dependent suppressor phenotype characterized by inhibition of stimulated T cell activation. This study aims to evaluate whether serum markers of neutrophil activation and complement at diagnosis of EOC would be associated with clinical outcomes.
Experimental Design: We conducted a two-center prospective study of patients with newly diagnosed EOC (N = 188).
Artificial Oxygen Carriers Save Lives in Expanded Access Use: Three Cases when Blood Was Not an Option.
Am J Ther
January 2025
Anesthesiology and Perioperative Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA.
Clinical Features: Sickle cell patients may develop a multitude of antibodies and experience life-threatening events with transfusion such as hyperhemolysis syndrome or delayed hemolytic transfusion reaction. Further transfusion may not be possible in such cases.
Therapeutic Challenge: When conventional blood products are not available for transfusion yet the patient requires additional oxygen-carrying support, artificial oxygen carriers may be required.
West Nile Neuroinvasive Disease: Case Series and Review of the Literature.
Am J Ther
January 2025
Department of Medicine, Long Island Jewish Forest Hills (Northwell Health), Forest Hills, NY.
Background: West Nile virus (WNV), although underdiagnosed, is the most common mosquito-borne disease and the second most common cause of viral encephalitis in the United States. Fewer than 1% of those infected develop neuroinvasive disease.
Methods: We present a cluster of 3 cases of neuroinvasive WNV that occurred between August and September 2023 and a review of the literature for neurologic involvement with this virus.
Challenges in acute postoperative pain management in thoracic surgery.
Best Pract Res Clin Anaesthesiol
March 2024
Department of Anesthesiology, Columbia University, 622 W 168th St, New York, 10032, NY, United States. Electronic address:
Effective pain control is crucial in the management of thoracic surgical patients since it reduces postoperative morbidity and promotes recovery. These patients have co-existing respiratory diseases and impaired pulmonary function, which may be further impaired by surgery. With the adoption of minimally invasive surgical techniques and an emphasis on enhancing recovery after surgery, multimodal analgesia has gained popularity as a way to reduce perioperative opioid use and its associated adverse events such as respiratory depression.
View Article and Find Full Text PDFClinical Profile and Management of Wolf-Parkinson White Syndrome and Asymptomatic Pre-Excitation Carriers in Africa: A Multicenter Pan African Registry From 17 Countries.
J Cardiovasc Electrophysiol
January 2025
Douala Gyneco-obstetric and Pediatric Hospital/University of Douala, Douala, Cameroon.
Background And Aim: Data are scarce regarding Wolf-Parkinson White Syndrome (WPW) syndrome and asymptomatic pre-excitation in Africa. This study tried to understand the current approaches utilized in Africa for the diagnosis and management of both symptomatic and asymptomatic ventricular pre-excitation.
Methods: The current prospective study was conducted in 20 centers located in 17 countries spanning all areas of Africa.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!