Thesis (M.Sc.) - Cairo University - Faculty of Medicine - Department of Cardiology

Background: Ischemic heart disease is the single most common cause of death worldwide. In order to increase the accuracy of the diagnosis, new diagnostic methods have been introduced, including miRNA-499, which is one of the most promising biomarkers in CAD, and acute myocardial infarction. Aim of the work: To evaluate the diagnostic value of circulating miRNA-499 versus high sensitivity cardiac troponin in early diagnosis of ST segment elevation myocardial infarction (STEMI) within the first 6 hours in emergency department. Subjects and methods: This study was conducted on 100 Egyptian adult patients who presented with STEMI during the first 6 hours of acute myocardial infarction (AMI) to the emergency department in Kasr Alainy Hospital and 30 healthy control volunteers. Serum samples from the patients and healthy subjects (controls) were analyzed using reverse transcription and real-time PCR by TaqMan® microRNA assays. Results: The concentration of miRNA-499 was significantly elevated in STEMI patients compared to healthy controls. Moreover, receiver-operating characteristic (ROC) curve analysis showed that AUC of 0.90 (95% CI, 0.845-0.955) with sensitivity and specificity of 89% and 83%, respectively with a PPV of 94% and NPV of 69% for STEMI detection. Furthermore, miRNA-499 displayed significant positive correlation with hs-cTnT. miRNA has more positive expression than hs-cTnT in the first three hours of chest pain in emergency department. Conclusion: MiRNA-499 can be used as reliable biomarker for the diagnosis of AMI and early detection of STEMI patients

Issued also as CD