The role of miR-21 as a biomarker and therapeutic target in cardiovascular disease

Cardiovascular diseases (CVDs) are the leading causes of death worldwide, accounting for a significant burden on global health systems. The complexity of CVDs arises from their multifactorial etiology, including genetic, environmental, and lifestyle factors. Early diagnosis and effective treatment remain critical for reducing mortality and improving patient outcomes, yet conventional methods often fall short in providing precise, timely information for disease management. MicroRNAs are small non-coding RNAs that regulate gene expression and play pivotal roles in various biological processes, including cardiovascular health. Among them, miR-21 has garnered significant attention due to its involvement in cardiac remodeling, fibrosis, inflammation, and hypertrophy. Elevated levels of miR-21 are frequently observed in conditions such as myocardial infarction, heart failure, and coronary artery disease, positioning it as a potential biomarker for early detection and disease progression. Furthermore, therapeutic strategies targeting miR-21, such as antagomirs and innovative delivery systems, have shown promise in preclinical studies, though challenges like off-target effects and delivery inefficiencies persist. This review aims to provide a comprehensive understanding of miR-21′s role in CVDs, addressing its potential as a diagnostic biomarker and therapeutic target. We discuss recent advancements, limitations, and future prospects in miR-21 research, emphasizing the importance of integrating this knowledge into clinical practice to improve CVD management.