Objective: Due to the increasing annual incidence rate of disability and mortality in patients with acute myocardial infarction (AMI), the need for an appropriate diagnostic tool has become a crucial urgent issue. An increase in biomarkers and protein levels in response to AMI can be used as a predictive biomarker with different sensitivities and specificities. This study aimed at investigating the role of miR-19a as a biomarker with acceptable sensitivity and specificity for early diagnosis of AMI. Methods: We studied 175 patients with AMI admitted within 12 h of symptom onset and 90 healthy subjects as control group. Patients were divided into two groups, including group I (normal vessels and no significant artery stenosis) and primary percutaneous coronary intervention (PCI) group II (patients with more than 50% stenosis in vessels and severe atherosclerosis) diagnosed by angiography. The expression level of miR-19a was evaluated by the real-time polymerase chain reaction and other serum chemistries were also analyzed. Results: The results demonstrated that circulating miR-19a levels were significantly increased in patient groups compared to the control group (2.88 ± 1.06 vs. 5.93 ± 1.28, P<0.0001). We also found that miR-19a levels were higher in group II (134.62-fold) than group I (15.42-fold). The upper levels of miR-19a were significantly correlated with the increased serum levels of CK-MB (ρ=0.29, P<0.0001), CTn I (ρ=0.4, P<0.0001) and creatinine (ρ=0.27, P<0.0001). In addition, Receiver Operating Characteristic (ROC) analysis revealed that circulating miR-19a had considerable diagnostic accuracy for the patients with normal vessel with an AUC of 0.930 (95% CI: 0.697-0.765) and for PCI patients with an AUC of 0.966 (95% CI: 0.748-0.784). Conclusion: Circulating miR-19a possibly has prognostic value to be used as a promising molecular target for early diagnosis and prognosis of AMI.

Purpose: Myocardial infarction (MI), known as a multifactorial disease, remains the predominant cause of mortality and sudden deaths annually. The current study aimed to measure the expression of microRNA-1 and microRNA-221-3p in MI patients. Methods: In the current study, 100 healthy controls (with no history of heart disease) and 200 patients with MI were selected. Patients were divided into two groups based on angiography results: normal (no significant artery stenosis) and primary percutaneous coronary intervention (primary PCI, significant artery stenosis). The levels of microRNA-1 and microRNA-221-3p were quantified using real-time quantitative polymerase chain reaction. The correlation between levels of microRNAs and the common cardiac markers were analyzed statistically. Results: In comparison to fold change, microRNA-1 elevations were 8.5-fold in normal patients and 60-fold in patients with primary PCI; while microRNA-221-3p levels were 210- fold higher in primary PCI and 31.31-fold higher in normal cases compared with the healthy controls. Receiver operating characteristic analysis showed that the area under the curve (AUC) for circulating microRNA-1 and microRNA-221 were 0.903 and 0.958 in normal patients and 0.927 and 0.985 in primary PCI patients (p <0.0001), respectively. Pearson correlation (ρ) analysis showed that circulation of microRNA-1 correlated with serum levels of cardiac troponin I (CTnI) (ρ=0.24), creatinine (ρ =0.34), creatinine kinase-myocardial band (CK-MB) (ρ=0.31), and microRNA-221-3p was significantly correlated with serum levels of CTnI (ρ =0.6), creatinine (ρ=0.41), and CK-MB (ρ=0.37), (P <0.0001). Conclusion: The study underscored the potential of microRNA-1 and microRNA-221-3p as informative biomarkers and positively correlated with artery stenosis in MI.

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Cardiovascular diseases are the most prevalent disease worldwide and pose a considerable threat to human health. Cytotoxic T lymphocyte-associated protein 4 (CTLA-4) plays a crucial role in the maintenance of immune diseases; however, its role in the progression of cardiovascular disorders is still unknown. The present study aimed to evaluate the relationship between CTLA-4 and myocardial infarction (MI). The Kyoto encyclopedia of genes and genomes database and the pathway studio database has revealed the role of CTLA4 as an inhibitory receptor on activated T cells. The relative expression of the CTLA-4 gene was assessed on the peripheral blood cells in 80 MI patients and 80 healthy individuals using quantitative real-time polymerase chain reaction (qRT-PCR) and also receiver operating characteristic (ROC) analysis was performed to evaluate the sensitivity and specificity of CTLA-4. We noticed the decreased expression of CTLA-4 levels in patients, compared to the control group (2.73±1.55 vs. 5.36±1.34). The study revealed the sensitivity of 0.89, specificity of 0.83, the accuracy of 0.9, and the area under the ROC curve (AUC) of 0.901 (95% CI: 0.727-0.776) for CTLA-4. The results highlighted the critical role of CTLA-4 as an inhibitory receptor in the maintenance of cardiovascular risks.