Abstract

Acute Myocardial infarction (AMI) is the leading cause of death worldwide. Diagnosis of AMI depends on presenting symptoms, electrocardiogram (ECG), and cardiac troponins (cTns). Troponins are not good markers for patients presenting at the first hour of chest pain, so there is still a need for a marker that can be detected within the first hour of presentation, with high specificity and sensitivity, guide the medical decisions and give good insight on the expected prognosis. Previous studies reported miR-208a as a cardiac specific microRNA that can be detected in the plasma as early as 15 min of cardiac insult and is stable in plasma for hours. But no study has investigated its role as a predictor of primary percutaneuos coronary angiography (PCI) outcome. The study objective was to investigate the diagnostic role of miR-208a in AMI and its ability to predict the outcome of primary PCI and in-hospital major adverse events (MACE). In the present study, 75 patients presented by chest pain to Zagazig University hospitals were enrolled into 2 groups. Group 1 included 40 patients diagnosed with ST-elevation myocardial infarction and underwent primary PCI, of them 21 had sufficient reperfusion and 19 had no-reflow. Group 2 had negative cTns. Institutional review board approval and consents according to the Helsinki declaration were obtained. Plasma expression of miR-208a was assessed in both groups and patients were followed along their hospital stay (range =6-96 hours). MicroRNA-208a was found to be a good marker for diagnosis of MI (AUC= 0.926) which was not inferior to cTns. There was no value of adding miR208a to the classic clinical model. miR-208a can predict in-hospital MACE (AUC=0.871) and no reflow (AUC=0.875) after primary PCI and is significantly superior to cTns in these outcomes. We conclude that miR-208a is a good diagnostic and prognostic marker of myocardial infarction and can predict no reflow after primary PCI.

School

School of Sciences and Engineering

Department

Biotechnology Program

Degree Name

MS in Biotechnology

Graduation Date

Spring 4-7-2020

Submission Date

4-7-2020

First Advisor

Azzazy, Hassan

Committee Member 1

Abdellatif, Ahmed

Committee Member 2

Othman, Khalid Said

Extent

82 p.

Document Type

Master's Thesis

Rights

The author retains all rights with regard to copyright. The author certifies that written permission from the owner(s) of third-party copyrighted matter included in the thesis, dissertation, paper, or record of study has been obtained. The author further certifies that IRB approval has been obtained for this thesis, or that IRB approval is not necessary for this thesis. Insofar as this thesis, dissertation, paper, or record of study is an educational record as defined in the Family Educational Rights and Privacy Act (FERPA) (20 USC 1232g), the author has granted consent to disclosure of it to anyone who requests a copy. The author has granted the American University in Cairo or its agents a non-exclusive license to archive this thesis, dissertation, paper, or record of study, and to make it accessible, in whole or in part, in all forms of media, now or hereafter known.

Institutional Review Board (IRB) Approval

Approval has been obtained for this item

Comments

Funded by AUC research grant

Creative Commons License

Creative Commons Attribution-No Derivative Works 4.0 International License
This work is licensed under a Creative Commons Attribution-No Derivative Works 4.0 International License.

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