Circulating microRNAs and Outcome in Patients with Acute Heart Failure

Circulating microRNAs and Outcome in Patients with Acute Heart Failure

Marie-France Seronde1,2, Mélanie Vausort3, Etienne Gayat2,4, Emeline Goretti3, Leong Ng5, Iain B. Squire5, Nicolas Vodovar2, Malha Sadoune2, Jane-Lise Samuel2, Thomas Thum6, Alain Cohen Solal2,7, Said Laribi2,8, Patrick Plaisance2,8, Daniel Wagner3, Alexandre Mebazaa2, Yvan Devaux3*, GREAT network. PLoS ONE 10(11):e0142237.doi:10.1371/journal.pone.0142237

Source : 1 Department of Cardiology, EA3920, University Hospital, Besançon, France, 2 UMRS 942 Inserm, University Paris Diderot, Paris, France, 3 Laboratory of Cardiovascular Research, Centre de Recherche Public de la Santé, Luxembourg, Luxembourg, 4 Department of Anesthesiology and Critical Care Saint Louis—Lariboisière Hospital, Paris, France, 5 University of Leicester and National Institute for Health Research, Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom, 6 Institute of Molecular and Translational Therapeutic Strategies (IMTTS), Hannover, Germany, 7 Department of Cardiology, Lariboisière Hospital, Paris, France, 8 Department of Emergency Medicine, Lariboisière Hospital, Paris, France

Abstract : Background : The biomarker value of circulating microRNAs (miRNAs) has been extensively addressed in patients with acute coronary syndrome. However, prognostic performances of miRNAs in patients with acute heart failure (AHF) has received less attention. Methods : A test cohort of 294 patients with acute dyspnea (236 AHF and 58 non-AHF) and 44 patients with stable chronic heart failure (CHF), and an independent validation cohort of 711 AHF patients, were used. Admission levels of miR-1/-21/-23/-126/-423-5p were assessed in plasma samples. Results : In the test cohort, admission levels of miR-1 were lower in AHF and stable CHF patients compared to non-AHF patients (p = 0.0016). Levels of miR-126 and miR-423-5p were lower in AHF and in non-AHF patients compared to stable CHF patients (both p<0.001). Interestingly, admission levels of miR-423-5p were lower in patients who were re-admitted to the hospital in the year following the index hospitalization compared to patients who were not (p = 0.0001). Adjusted odds ratio [95% confidence interval] for one-year readmission was 0.70 [0.53–0.93] for miR-423-5p (p = 0.01). In the validation cohort, admission levels of miR-423-5p predicted 1-year mortality with an adjusted odds ratio [95% confidence interval] of 0.54 [0.36–0.82], p = 0.004. Patients within the lowest quartile of miR-423-5p were at high risk of long-term mortality (p = 0.02). Conclusions : In AHF patients, low circulating levels of miR-423-5p at presentation are associated with a poor long-term outcome. This study supports the value of miR-423-5p as a prognostic biomarker of AHF.