Reza Parvan, Victoria Becker, Milad Hosseinpour, Yousef Moradi, William E Louch, Alessandro Cataliotti, Yvan Devaux, Michael Frisk, Gustavo Jose Justo Silva
{"title":"射血分数降低或保留的心力衰竭患者的预后和预测microRNA面板：基于kaplan - meier个体患者数据的荟萃分析。","authors":"Reza Parvan, Victoria Becker, Milad Hosseinpour, Yousef Moradi, William E Louch, Alessandro Cataliotti, Yvan Devaux, Michael Frisk, Gustavo Jose Justo Silva","doi":"10.1186/s12916-025-04238-0","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Cardiac troponins and natriuretic peptides are benchmark biomarkers for heart failure (HF) with reduced ejection fraction (HFrEF) but have limited prognostic performance for HF patients with preserved ejection fraction (HFpEF). Non-coding RNA-based biomarkers represent an innovative approach to risk-stratify patients and might address the unmet need for minimally invasive prognostic and predictive tools for HF development and HF-related outcomes. Our aim is to investigate the prognostic performance and risk stratification potential of circulating panels of microRNAs (miRNAs) in HFrEF and HFpEF.</p><p><strong>Methods: </strong>A systematic search on PubMed, Web of Science, and Scopus databases was performed for studies reporting miRNAs as prognostic biomarkers in HF patients. A total of 22 studies pooling 5736 participants were included for quantitative analysis. KM-based individual patient data (IPD) analysis was performed in 12 studies (5064 participants).</p><p><strong>Results: </strong>KM-based IPD analysis in HFrEF allowed the identification of a panel of four miRNAs (miR-27a-3p, miR-129-5p, miR-145-5p, and miR-590-3p) predicting the risk of all-cause death with hazard ratio (HR) 4.26 [2.68-6.76]. MiR-122-5p and miR-423-5p predicted cardiovascular death of HFrEF patients (HR 3.61 [2.67-4.87]). In HFpEF, miR-19a-3p predicted all-cause death of HFpEF patients with HR 2.23 [1.16-4.27]. Moreover, a panel of eight miRNAs (miR-17-5p, miR-20a-5p, miR-21, miR-23, miR-27, miR-106b-5p, miR-210, and miR-221) showed significant association with HF incidence (HR 2.14 [1.81-2.53]).</p><p><strong>Conclusions: </strong>A comprehensive meta-analysis of KM-based IPD enabled the identification of unique miRNA panels predicting the incidence and severity of HFrEF and HFpEF, supporting the clinical usefulness of miRNA profiling for tailored healthcare and risk stratification in HF patients. Nonetheless, more rigorously designed longitudinal studies are needed to validate the clinical application of miRNAs as prognostic and predictive biomarkers.</p>","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"409"},"PeriodicalIF":7.0000,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12235814/pdf/","citationCount":"0","resultStr":"{\"title\":\"Prognostic and predictive microRNA panels for heart failure patients with reduced or preserved ejection fraction: a meta-analysis of Kaplan-Meier-based individual patient data.\",\"authors\":\"Reza Parvan, Victoria Becker, Milad Hosseinpour, Yousef Moradi, William E Louch, Alessandro Cataliotti, Yvan Devaux, Michael Frisk, Gustavo Jose Justo Silva\",\"doi\":\"10.1186/s12916-025-04238-0\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Cardiac troponins and natriuretic peptides are benchmark biomarkers for heart failure (HF) with reduced ejection fraction (HFrEF) but have limited prognostic performance for HF patients with preserved ejection fraction (HFpEF). Non-coding RNA-based biomarkers represent an innovative approach to risk-stratify patients and might address the unmet need for minimally invasive prognostic and predictive tools for HF development and HF-related outcomes. Our aim is to investigate the prognostic performance and risk stratification potential of circulating panels of microRNAs (miRNAs) in HFrEF and HFpEF.</p><p><strong>Methods: </strong>A systematic search on PubMed, Web of Science, and Scopus databases was performed for studies reporting miRNAs as prognostic biomarkers in HF patients. A total of 22 studies pooling 5736 participants were included for quantitative analysis. KM-based individual patient data (IPD) analysis was performed in 12 studies (5064 participants).</p><p><strong>Results: </strong>KM-based IPD analysis in HFrEF allowed the identification of a panel of four miRNAs (miR-27a-3p, miR-129-5p, miR-145-5p, and miR-590-3p) predicting the risk of all-cause death with hazard ratio (HR) 4.26 [2.68-6.76]. MiR-122-5p and miR-423-5p predicted cardiovascular death of HFrEF patients (HR 3.61 [2.67-4.87]). In HFpEF, miR-19a-3p predicted all-cause death of HFpEF patients with HR 2.23 [1.16-4.27]. Moreover, a panel of eight miRNAs (miR-17-5p, miR-20a-5p, miR-21, miR-23, miR-27, miR-106b-5p, miR-210, and miR-221) showed significant association with HF incidence (HR 2.14 [1.81-2.53]).</p><p><strong>Conclusions: </strong>A comprehensive meta-analysis of KM-based IPD enabled the identification of unique miRNA panels predicting the incidence and severity of HFrEF and HFpEF, supporting the clinical usefulness of miRNA profiling for tailored healthcare and risk stratification in HF patients. 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引用次数: 0
摘要
背景：心脏肌钙蛋白和利钠肽是心力衰竭（HF）伴射血分数降低（HFrEF）的基准生物标志物，但对保留射血分数（HFpEF）的心衰患者预后的影响有限。基于非编码rna的生物标志物代表了一种对患者进行风险分层的创新方法，并可能解决对HF发展和HF相关结局的微创预后和预测工具的未满足需求。我们的目的是研究HFrEF和HFpEF中循环microRNAs （miRNAs）的预后表现和风险分层潜力。方法：系统检索PubMed、Web of Science和Scopus数据库，对报道mirna作为心衰患者预后生物标志物的研究进行检索。共纳入22项研究，共纳入5736名受试者进行定量分析。在12项研究（5064名参与者）中进行了基于km的个体患者数据（IPD）分析。结果：在HFrEF中基于km的IPD分析允许鉴定一组四种mirna (miR-27a-3p, miR-129-5p， miR-145-5p和miR-590-3p)，预测全因死亡风险，风险比（HR）为4.26[2.68-6.76]。MiR-122-5p和miR-423-5p预测HFrEF患者心血管死亡（HR 3.61[2.67-4.87]）。在HFpEF中，miR-19a-3p预测HFpEF患者全因死亡的HR为2.23[1.16-4.27]。此外，一组8种mirna （miR-17-5p、miR-20a-5p、miR-21、miR-23、miR-27、miR-106b-5p、miR-210和miR-221）显示与HF发病率显著相关（HR 2.14[1.81-2.53]）。结论：基于km的IPD的综合荟萃分析能够识别出预测HFrEF和HFpEF发病率和严重程度的独特miRNA组，支持miRNA分析在HF患者量身定制医疗保健和风险分层方面的临床应用。尽管如此，需要更严格设计的纵向研究来验证mirna作为预后和预测性生物标志物的临床应用。
Prognostic and predictive microRNA panels for heart failure patients with reduced or preserved ejection fraction: a meta-analysis of Kaplan-Meier-based individual patient data.
Background: Cardiac troponins and natriuretic peptides are benchmark biomarkers for heart failure (HF) with reduced ejection fraction (HFrEF) but have limited prognostic performance for HF patients with preserved ejection fraction (HFpEF). Non-coding RNA-based biomarkers represent an innovative approach to risk-stratify patients and might address the unmet need for minimally invasive prognostic and predictive tools for HF development and HF-related outcomes. Our aim is to investigate the prognostic performance and risk stratification potential of circulating panels of microRNAs (miRNAs) in HFrEF and HFpEF.
Methods: A systematic search on PubMed, Web of Science, and Scopus databases was performed for studies reporting miRNAs as prognostic biomarkers in HF patients. A total of 22 studies pooling 5736 participants were included for quantitative analysis. KM-based individual patient data (IPD) analysis was performed in 12 studies (5064 participants).
Results: KM-based IPD analysis in HFrEF allowed the identification of a panel of four miRNAs (miR-27a-3p, miR-129-5p, miR-145-5p, and miR-590-3p) predicting the risk of all-cause death with hazard ratio (HR) 4.26 [2.68-6.76]. MiR-122-5p and miR-423-5p predicted cardiovascular death of HFrEF patients (HR 3.61 [2.67-4.87]). In HFpEF, miR-19a-3p predicted all-cause death of HFpEF patients with HR 2.23 [1.16-4.27]. Moreover, a panel of eight miRNAs (miR-17-5p, miR-20a-5p, miR-21, miR-23, miR-27, miR-106b-5p, miR-210, and miR-221) showed significant association with HF incidence (HR 2.14 [1.81-2.53]).
Conclusions: A comprehensive meta-analysis of KM-based IPD enabled the identification of unique miRNA panels predicting the incidence and severity of HFrEF and HFpEF, supporting the clinical usefulness of miRNA profiling for tailored healthcare and risk stratification in HF patients. Nonetheless, more rigorously designed longitudinal studies are needed to validate the clinical application of miRNAs as prognostic and predictive biomarkers.
期刊介绍：
BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.
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