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Key questions What is already known about this subject?
The role of microRNAs (miRNAs) in patients with coronary artery calcification (CAC) has not been examined.
What does this study add?
We have identified miRNA 8059 to be significantly downregulated in patients with extensive CAC.
How might this impact on clinical practice?
miRNA 8059 may serve as a novel biomarker for the presence and extent of CAC, as well as provide a platform to study the molecular mechanism underpinning vascular calcification.
Background
Atherosclerotic coronary artery disease (CAD) remains the most common cause of morbidity and mortality in the Western world. 1 In approximately 50% of individuals, the initial presentation of CAD is a myocardial infarction or sudden cardiac death. As a consequence, international guidelines such as the American Heart Association and the European Society of Cardiology have recommended the use of screening tests to identify high-risk individuals. 2 3 However, conventional clinic-based models such as the Framingham Risk Score, which creates three categories of 10-year risk for a future cardiovascular event, can only predict 60%-65% of individuals at risk of a cardiovascular event, and are therefore unable to identify many individuals who go on to have an acute cardiac event. 4 Recent studies have focused on the assessment of the degree of coronary artery calcification (CAC) as a risk assessment tool for cardiovascular events. The clinical utility of coronary CT for the assessment of CAC and the presence of obstructive CAD has been well validated, but its applicability may be limited by cost, poor image quality in patients with obesity and its relative contraindication in patients with renal impairment and contrast allergy. 5-8 MicroRNAs (miRNAs) are short, non-coding RNAs that regulate gene expression by annealing to partially complementary sites on the 3' untranslated region of messenger RNA (mRNA) to suppress their translation. 9 A number of studies have demonstrated the clinical utility of miRNAs in the diagnosis and prognosis of a number of cardiovascular disorders such as myocardial infarction, stable angina and heart failure. 10-12 Furthermore, recent studies have also identified miRNAs to play a role in arterial calcification; for example, miRNA-204 and miRNA-125b have been implicated in vascular smooth muscle calcification in in vitro models. 13 14 As a consequence, identification of an 'miRNA signature'...