Cardiolinc members identify a new circular RNA that can predict outcome after myocardial infarction

A publication in the Journal of the American College of Cardiology (JACC) reveals a newly identified circular RNA that can predict patient outcome after acute myocardial infarction. This work is the collaborative effort between three research groups of the Cardiolinc network: Cardiovascular Research Unit of the  Luxembourg Institute of Health, University of Leipzig (Germany) and Institute of Cardiology (Poland).

Medicine has greatly improved survival of patients suffering a an acute myocardial infarction, but it still hasn’t been able to decrease subsequent damage to the heart muscle. While many patients recover from a heart attack, a significant percentage develop the life threatening condition left ventricular dysfunction. About 60% of those patients die within 5 years after the acute myocardial infarction.

Existing tools to detect patients at risk of developing left ventricular dysfunction have serious limitations, making the discovery of novel prognostic biomarkers essential. The study led by the Cardiovascular Research Unit in the Luxembourg Institute of Health focused on finding candidate non-coding RNA molecules to be used as biomarkers. The researchers unveiled a new circular RNA, called MICRA (Myocardial Infarction-associated Circular RNA), as predictor of left ventricular dysfunction after myocardial infarction using blood samples from 409 patients of the national registry of patients with myocardial infarction in Luxembourg (LUCKY registry). Patients with low levels of MICRA in their blood were found to be at high risk to develop left ventricular dysfunction. 

The discovery was then validated in an independent group of 233 heart attack patients from the German LIFE-Leipzig study by collaborators from the Faculty of Medicine at the University of Leipzig, Germany. In addition, the Institute of Cardiology in Warsaw, Poland, verified that the levels of MICRA in the left ventricle of patients with end-stage heart failure indicate that this circular RNA could play a role in development of left ventricular dysfunction.

The use of RNAs as biomarkers for various diseases is an active topic of investigation. While it has been suggested that different types of RNA have potential for this purpose, this is the first study showing that circular RNAs can be used as cardiac biomarkers. Yvan Devaux, Deputy Head of the Cardiovascular Research Unit, has also presented these exciting results of the publication at the European Society of Cardiology Congress in Rome in late August, where it was also featured at the Basic Science Highlights session at the end of the event. 

Although further studies are necessary to confirm the use of MICRA as prognostic biomarker, these findings are highly relevant in the context of personalized medicine. In parallel to developing a prognostic test that can be used in the clinic, investigating the role and regulation of circular RNAs in cardiovascular disease may reveal further fields of application.