Editors' ChoiceMyocardial Infarction

Long Noncoding RNAs in Myocardial Infarction

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Science Translational Medicine  30 Jul 2014:
Vol. 6, Issue 247, pp. 247ec131
DOI: 10.1126/scitranslmed.3009818

The study of long noncoding RNA (lncRNA) has produced a number of exciting and sophisticated results in recent years, with clinical implications across a variety of fields. However, patients with acute myocardial infarction (heart attack) have largely remained absent from this scientific progress. Because of the rapid onset of disease and inaccessibility of the primary organ to routine biopsy, transcriptional regulation of lncRNA has been mainly studied in animal models of heart attack. However, in an exciting study by Vausort et al., lncRNA changes are seen in the peripheral blood of patients with recent myocardial infarction, suggesting multiple possibilities for future research.

The study started with the recruitment of 414 patients with acute myocardial infarction. The authors then measured five lncRNAs, all of which are known to regulate pathways highly relevant to cardiac function. These were aHIF (involved in heart failure and angiogenesis), ANRIL (a known predictor of coronary artery disease), KCNQ1OT1 (correlates with dysrhythmia and a known risk factor for heart attack), MIAT (associated with myocardial infarction), and MALAT1 (a splicing regulator). All but one showed a statistically significant difference as compared with healthy controls, with the most dramatic difference seen for aHIF, a known correlate of heart failure and hypoxia. The findings suggest that lncRNAs in peripheral blood can be dynamically regulated in mere hours. Interestingly, aHIF levels, although up-regulated overall, appeared to vary with time in the period after infarction, suggesting that they may have similar kinetics to established biomarkers of heart attack, such as troponin and creatine kinase.

Although the findings are compelling, uncovering the underlying mechanisms and deciphering the lncRNA correlates of general inflammation versus cardiac-specific pathology will take more work. Nevertheless, with the discovery of measurable, dynamic, and differentially regulated lncRNA in the peripheral blood of patients with acute myocardial infarction, the field is wide open with a new and powerful tool.

M. Vausort et al., Long non-coding RNAs in patients with acute myocardial infarction. Circ. Res. 10.1161/CIRCRESAHA.115.303836 (2014). [Abstract]

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