Role of polymorphisms and microRNA levels in predicting cardiovascular events in patients with acute myocardial infarction

Abstract

Acute myocardial infarction (AMI) remains a leading global cause of morbidity and mortality, with high risk of recurrent adverse cardiovascular events. Conventional diagnostic markers often lack the sensitivity needed for early detection and prognostic stratification. Recent advances highlight the role of microRNAs (miRNAs) and their genetic polymorphisms in regulating inflammation, fibrosis, and endothelial function in atherosclerotic disease. This review summarizes evidence on circulating miRNA expression and miRNA-related single nucleotide polymorphisms as biomarkers in AMI. Literature from PubMed, Scopus, and Web of Science was evaluated, focusing on pathways involving NF-κB, interleukin-1 receptor/toll-like receptors, and JAK/STAT signaling. Circulating miRNAs such as miR-150, miR-208, miR-26a, and miR-483-5p demonstrate strong diagnostic accuracy, while polymorphisms, particularly rs2910164 in miR-146a, are consistently associated with AMI susceptibility and adverse outcomes. These findings suggest that miRNAs and their variants may serve as non-invasive tools for diagnosis and risk prediction, supporting future integration into precision cardiovascular medicine.

Keywords: Acute myocardial infarction; Circulating microRNA; Major adverse cardiovascular event; Coronary artery disease; MicroRNA polymorphism

Core Tip: Acute myocardial infarction (AMI) remains a leading cause of morbidity and mortality worldwide, and traditional biomarkers offer limited prognostic value. This review highlights the emerging significance of circulating microRNAs (miRNAs)-particularly miR-150, miR-208, miR-26a, and miR-483-5p and genetic polymorphisms such as rs2910164 in miR-146a in predicting AMI risk and major adverse cardiovascular events. These biomarkers regulate inflammation and endothelial dysfunction through key pathways, nuclear factor-kappaB, and nterleukin-1 receptor/toll-like receptors signaling. Integrating miRNA profiling with clinical assessment may enhance early diagnosis and enable personalized risk stratification in AMI patients.