Coronary Heart Disease Transcoronary Concentration Gradients of Circulating MicroRNAs

Background—Circulating levels of microRNA (miR) have been proposed as biomarkers for cardiovascular disease. To identify the heart as a potential source for miRs released into the circulation, we measured concentration gradients across the coronary circulation for muscle-enriched (miR-133a, miR-499, miR-208a), vascular (miR-126, miR-92a), leukocyterelated (miR-155), and platelet-enriched (miR-223) miRs. Methods and Results—Circulating miRs were measured by TaqMan polymerase chain reaction in EDTA-plasma simultaneously obtained from the aorta and the coronary venous sinus in patients without coronary artery disease (n 7), with stable coronary artery disease (n 31), and with troponin-positive acute coronary syndromes (n 19). Circulating levels of the muscle-enriched miR-499 ( 20-fold; P 0.01), miR-133a (11-fold; P 0.01), and miR-208a (5-fold; P 0.01) were significantly elevated in the aorta of troponin-positive acute coronary syndrome patients compared with patients with coronary artery disease. Importantly, there was a significant increase in circulating levels of miR-499 and miR-133a across the coronary circulation in troponin-positive acute coronary syndrome patients, suggestive of a release into the coronary circulation during myocardial injury. Indeed, miR-499 concentration gradients were significantly correlated with the extent of myocardial damage as measured by high-sensitivity troponin T (r 0.70, P 0.01). In contrast, circulating levels of miR-126 (P 0.16) decreased during transcoronary passage in patients with evidence of myocardial injury, suggesting consumption during transcoronary passage. Conclusions—Muscle-enriched miR-499 and miR-133a are released from the heart into the coronary circulation on myocardial injury, whereas the vascular miR-126 is consumed during transcoronary passage. The differential regulation of circulating miRs during the transcoronary passage might provide important insights to exploit their role as cardiac biomarkers. Clinical Trial Registration—URL: http://www.germanctr.de. Unique identifier: DRKS00000207; in German Clinical Trials Registry. (Circulation. 2011;124:1936-1944.)