Affiliations 

  • 1 Departments of Clinical Epidemiology, Biostatistics and Bio-informaticsAmsterdam UMC, location AMC Amsterdam The Netherlands
  • 2 Department of Experimental CardiologyAmsterdam UMC, location AMC Amsterdam The Netherlands
  • 3 ACS Biomarker B.V. Amsterdam The Netherlands
  • 4 The National University Heart Center Singapore Singapore
  • 5 Program in Cardiovascular and Metabolic Disorders Duke-National University of SingaporeGraduate Medical School Singapore Singapore
  • 6 Cardiovascular Research InstituteYong Loo Lin School of MedicineNational University of Singapore Singapore Singapore
  • 7 Christchurch Heart InstituteUniversity of Otago Christchurch New Zealand
  • 8 Clinical Research Centre Sarawak General Hospital Kuching Malaysia
  • 9 Department of Medicine & Therapeutics The Chinese University of Hong Kong Hong Kong China
J Am Heart Assoc, 2021 01 19;10(2):e017120.
PMID: 33441016 DOI: 10.1161/JAHA.120.017120

Abstract

Background Because of a nonresponse to aspirin (aspirin resistance), patients with acute coronary syndrome (ACS) are at increased risk of developing recurrent event. The in vitro platelet function tests have potential limitations, making them unsuitable for the detection of aspirin resistance. We investigated whether miR-19b-1-5p could be utilized as a biomarker for aspirin resistance and future major adverse cardio-cerebrovascular (MACCE) events in patients with ACS. Methods and Results In this cohort study, patients with ACS were enrolled from multiple tertiary hospitals in Christchurch, Hong Kong, Sarawak, and Singapore between 2011 and 2015. MiR-19b-1-5p expression was measured from buffy coat of patients with ACS (n=945) by reverse transcription quantitative polymerase chain reaction. Platelet function was determined by Multiplate aggregometry testing. MACCE was collected over a mean follow-up time of 1.01±0.43 years. Low miR-19b-1-5p expression was found to be related to aspirin resistance as could be observed from sustained platelet aggregation in the presence of aspirin (-Log-miR-19b-1-5p, [unstandardized beta, 44.50; 95% CI, 2.20-86.80; P<0.05]), even after adjusting for age, sex, ethnicity, and prior history of stroke. Lower miR-19b-1-5p expression was independently associated with a higher risk of MACCE (-Log-miR-19b-1-5p, [hazard ratio, 1.85; 95% CI, 1.23-2.80; P<0.05]). Furthermore, a significant interaction was noted between the inverse miR-19b-1-5p expression and family history of premature coronary artery disease (P=0.01) on the risk of MACCE. Conclusions Lower miR-19b-1-5p expression was found to be associated with sustained platelet aggregation on aspirin, and a higher risk of MACCE in patients with ACS. Therefore, miR-19b-1-5p could be a suitable marker for aspirin resistance and might predict recurrence of MACCE in patients with ACS.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.