A Study Of Plasma MicroRNA As A Novel Potential Biomarker For Diagnosing Acute Aortic Dissection

Objectives: Acute aortic dissection (AAD) is a danger cardiovascular disease with highmortality and misdiagnosis rate(39%), which is a catastrophic clinical emergency firstdescribed by Morgagni more than200years ago. Rapid diagnosis and initiation of treatmentis pivotal for patients with acute aortic dissection. So far, there is no laboratory test to aidthe diagnosis. And circulating microRNAs (miRNA) might represent a novel class ofbiomarkers for diseases. The purpose of this research was to determine whether circulatingmicroRNAs allow to distinguish AAD not only from healthy controls but also from chestpain (CP) patients without AAD forms of acute myocardial infarction (AMI), aorticaneurysm (AA) and pulmonary embolism (PE).Methods: Plasma microRNAs expression were determined in103participants, including63aortic dissection (AD) patients (37patients with AAD and26patients with subacute aorticdissection) and40controls (including17healthy volunteers,11patients with AMI,10patients with AA and2patients with PE), recruited between February2011and July2012.First, we used microarray to screen1,205human microRNAs and142viral microRNAs in24plasma samples (AAD group, n=8; control group [including8healthy volunteers and8AA patients], n=16). Quantitative reverse-transcriptase polymerase chain (qRT-PCR) assaywas then applied to evaluate the expression of selected microRNAs in all participants. Thearea under the receiver operating characteristic curve (AUC) was used to evaluate diagnosticaccuracy.Results: We selected16microRNAs from microarray screening as candidates for furthertesting via qRT-PCR. The results showed that plasma miR-15a in patients with AAD (n=37)had significantly higher expression levels than it from control group (n=40; P=0.008, foldchange=2.795). By receiver operating characteristic curve analysis, the sensitivity was75.7%; the specificity was82.5%; and the AUC was0.761for detection of AAD.Furthermore,37patients with AAD had significantly higher plasma expression levels of let-7b, miR-15a, miR-23a and hcmv-miR-US33-5p compared with14CP patients of40controls(P=0.000,0.000,0026and0.011, respectively; fold change=8.462,8.938,17.851and21.975,respectively). The corresponding sensitivity were79.4%,75.7%,91.9%and73.5%,respectively; the specificity were92.9%,100%,85.7%and85.7%, respectively; and theAUCs of these microRNAs were0.887,0.855,0.925and0.815, respectively. Conclusions: The plasma miR-15a and miR-23a that have promising clinical value indiagnosing AAD. Thus, patients who would have otherwise missed the curative treatmentwindow, can benefit from the optimal therapy.