Circulating MicroRNAs as Biomarkers in Cardiovascular Disease

Circulating microRNAs are short, non-coding RNA molecules that enter the bloodstream following cellular stress or injury in the heart. They remain remarkably stable in plasma and serum, resisting RNase degradation and reflecting underlying pathophysiological processes. In cardiovascular disease, distinct profiles of these miRNAs offer insights into acute events such as myocardial infarction, chronic conditions such as coronary artery disease and subsequent remodelling of the myocardium. Panels of circulating miRNAs have demonstrated diagnostic accuracy comparable to traditional markers, while also providing prognostic information on left ventricular function and risk of adverse outcomes. Recent work has combined global transcriptome-level surveys with machine-learning algorithms to refine miRNA signatures, enabling discrimination between stable and unstable coronary syndromes and facilitating early, time-sensitive intervention. Despite promising clinical applications, challenges remain in standardising pre-analytical protocols, normalising quantification methods and ensuring specificity across diverse patient populations. Ongoing integration with point-of-care technologies and computational models is poised to translate these biomarkers into routine practice for risk stratification, therapy guidance and long-term follow-up in cardiovascular medicine.

Research from Nature Portfolio

Recent studies have identified a diagnostic signature comprising reduced levels of miR-145, miR-155 and let-7c in patients with coronary artery disease. Measurements in well-matched cohorts demonstrated that low circulating concentrations of these miRNAs are independently associated with disease presence. Combined analysis of the three markers improves specificity and sensitivity compared with any single miRNA, offering a robust non-invasive tool for early detection of coronary pathology. Receiver operating characteristic analyses confirm the high discriminative power of this trio, while logistic regression highlights their potential in multivariable risk models.

Circulating MicroRNAs as Biomarkers in Cardiovascular Disease publication trend

The graph below shows the total number of articles in circulating micrornas as biomarkers in cardiovascular disease across all publications each year (not limited to Nature Index journals).

Technical terms

microRNA (miRNA): A small (~22 nucleotides) non-coding RNA that regulates gene expression post-transcriptionally.

Biomarker: A measurable indicator of a biological or pathological process, used for diagnosis or prognosis.

Transcriptome profiling: Quantitative analysis of the full set of RNA transcripts in a sample, often by sequencing.

Receiver operating characteristic (ROC) curve: A plot of true-positive rate versus false-positive rate used to assess diagnostic test performance.

Area under the curve (AUC): A summary measure of the ROC curve; higher values indicate better discrimination.

Point-of-care device: A diagnostic tool designed for use at the patient’s bedside or in a clinic, enabling rapid results.

References

1. Global surveillance of circulating microRNA for diagnostic and prognostic assessment of acute myocardial infarction based on the plasma small RNA sequencing. Biomarker Research (2024).
2. Unlocking the potential of microRNAs: machine learning identifies key biomarkers for myocardial infarction diagnosis. Cardiovascular Diabetology (2023).
3. Towards real-time myocardial infarction diagnosis: a convergence of machine learning and ion-exchange membrane technologies leveraging miRNA signatures. Lab on a Chip (2024).
4. Diagnostic Potential of Plasmatic MicroRNA Signatures in Stable and Unstable Angina. PLOS ONE (2013).
5. Circulating miR-155, miR-145 and let-7c as diagnostic biomarkers of the coronary artery disease. Scientific Reports (2017).