The value of miRNA-29b in the diagnosis of myocardial infarction and the evaluation of cardiac function after myocardial infarction.

Background: miRNA-29b affects angiogenesis and cardiac fibrosis, processes relevant to the pathophysiology of myocardial infarction (MI). This study aimed to investigate the accuracy of miRNA-29b in diagnosing acute myocardial infarction (AMI) and its association with postinfarction cardiac function.

Methods: A total of 106 patients with AMI admitted to the Department of Cardiology of Hebei General Hospital between January 2023 and July 2024 were prospectively enrolled within 24 hours of symptom onset. Indicators including circulating miRNA-29b levels [detected via real-time quantitative polymerase chain reaction (RT-qPCR)], myocardial enzymes, vascular endothelial growth factor (VEGF), and tumor necrosis factor-α (TNF-α) were assessed at baseline. Cardiac function was assessed by echocardiography. Left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), left ventricular end-diastolic diameter (LVEDd), left ventricular end-systolic diameter (LVEDs), and left ventricular posterior wall thickness at end-diastole (LVPWd) and end-systole (LVPWs) were also measured. Based on echocardiography, patients with AMI (n=106) were divided into an abnormal cardiac function (ACF) group (LVEF <50%; n=50) or a normal cardiac function (NCF) group (LVEF ≥50%; n=56). Thirty healthy participants were selected as the control group. Variables were compared with independent samples t-tests. Correlation and receiver operating characteristic (ROC) curve analyses were also conducted.

Results: There was no significant differences in baseline demographic or clinical characteristics between the AMI and control groups; however, the control group, compared with the AMI group, had lower levels of low-density lipoprotein cholesterol (2.72±0.58 vs. 3.53±0.77 mmol/L; P<0.001) and fasting blood glucose (7.00±1.61 vs. 8.77±2.37 mmol/L; P<0.001). Moreover, the relative blood miRNA-29b expression was significantly lower in the AMI group than in the control group (0.31±0.16 vs. 0.73±0.40; P<0.01), and the expression was lower in the ACF group than in the NCF group (0.24±0.15 vs. 0.39±0.14; P<0.01). Correlation analysis showed that miRNA-29b was positively correlated with LVEF [r=0.608; P<0.001; 95% confidence interval (CI): 0.494-0.701] and LVFS (r=0.583; P<0.001; 95% CI: 0.448-0.702). Conversely, it was negatively correlated with cardiac troponin T (cTnT) level (r=-0.687; P<0.001; 95% CI: -0.769 to -0.610), creatine kinase-MB (r=-0.626; P<0.001; 95% CI: -0.744 to -0.488), VEGF (r=-0.581; P<0.001, 95% CI: -0.708 to -0.422), TNF-α (r=-0.527; P<0.001; 95% CI: -0.658 to -0.369), LVEDd (r=-0.451; P<0.001; 95% CI: -0.578 to -0.284), and LVEDs (r=-0.462; P<0.001; 95% CI: -0.593 to -0.330). ROC analysis indicated good diagnostic performance of miRNA-29b for AMI [area under the curve (AUC) =0.853; 95% CI: 0.767-0.939], and miRNA-29b also showed predictive value for postinfarction cardiac dysfunction (AUC =0.797; 95% CI: 0.673-0.920).

Conclusions: Blood miRNA-29b is lower in patients with AMI, particularly in those with impaired cardiac function. miRNA-29b demonstrates potential value in the diagnosis of AMI and the assessment of postinfarction cardiac function.