Acute Coronary Syndromes (ACS) are the major cause of cardiovascular mortality. The main factor affecting worse prognoses in patients with ACS is the size of the ischemia-reperfusion injury (IRI). The size of this injury is influenced by the co-existing diseases and cardiovascular risk factors. Unfortunately, there are no effective methods and tools enabling prognostic assessment of the IRI size, and thus enabling better planning of individual procedure in the event that ACS occurs in increased-risk patients. The interest of the researchers searching for an innovative biomarker is focused on miRNA molecules circulating in blood. These are short non-coding RNAs with a length of approximately 22 nucleotides which mediate in silencing of the expression of genes. They regulate metabolism of cardiomyocytes and therefore change the exposure of the cardiac muscle to injuries.
The subject-matter of the project is a prospective study aiming at the assessment whether exosomal miRNAs may be a useful prognostic marker for the size of the ischemia-reperfusion injury. We propose an innovative approach consisting in an analysis of the miRNA molecules’ profile inside the circulating exosomes which are affected by particular risk-factors.
These studies will enable better assessment of patients’ prognoses and implementation of more adequate treatment methods to decrease ACS-related mortality. This corresponds with the subject-matter of the programme in the scope of conducting scientific research or development studies, in particular those aimed at creating or modernisation of technologies or technical solutions, and in promotion of their results; yet, in the future perspective, also by means of potential transfer of the results of the conducted scientific research or developmental studies to the economic sphere. The study focuses on civilisation diseases creating fundamental economic and social problems. The results obtained will help development of solutions, within local, national, as well as international range, which are to contribute to solving those problems in a better way, and thanks to which, contribute to better social development of the country. Laboratory research will be conducted in the Academic Department and Institute of Experimental and Clinical Physiology of the MUW’s Pre-Clinical Research Centre. The exosomes will be isolated with column chromatography method from serum taken by medical personnel from patients admitted to Szpital Zachodni in Grodzisk Mazowiecki due to acute myocardial infarction. RNA will be isolated from the received exosomes and expression of particular miRNA molecules will be assessed. From the patients of Szpital Zachodni in Grodzisk Mazowiecki included in the study, by means of echocardiographic examination, we will obtain information regarding the size of the area of cardiac muscle affected by the infarction and its systolic and diastolic function. Additionally, we will estimate the risk of cardiovascular mortality in each examined patient; we will measure the waist circumference, make a body composition analysis and the body mass index (BMI) will be calculated. These data will be juxtaposed with the level of expression of particular miRNA, selected based on previous research into their possible influence on the exposure of the cardiac muscle to the ischemia-reperfusion injury. The patients will be subject to a 6-month observation, during which we will collect data on the cardiovascular mortality and non-mortal infarction or stroke, repeated hospitalisation due to cardiological reasons, which will also be juxtaposed with the initial miRNA expression in order to estimate their prognostic value.