The prognostic value of platelet-derived microRNAs in patients with acute coronary syndrome treated with new P2Y12 receptor antagonists

Cardiovascular diseases, including acute coronary syndromes (ACS), are the most significant cause of death on a global scale. In 2009 alone, the global cost of treating cardiovascular disease was estimated at € 106 billion. Every year, over 1.1 million new ACS cases are registered in the European Union. Prevention of ACS and their recurrences
would therefore allow a reduction in mortality, prevent disability and lower the cost of treatment. ACS is based on the activation and aggregation of platelets on the ruptured atherosclerotic plaque, which leads to the formation of a blood clot in the lumen of the coronary artery, impaired blood flow and, ultimately, necrosis of the heart muscle. Inhibition of platelet function by the use of antiplatelet drugs (antagonists of the platelet P2Y12 receptor - ticagrelor or prasugrel) is the most effective strategy available today to prevent recurrent ischemic events after ACS. Unfortunately, despite optimal antiplatelet therapy, approximately 10% of ACS patients experience another ischemic episode within a year. Identification of these patients is currently not possible.

MicroRNAs (miRNAs) are small, non-coding RNAs that regulate the expression of 60% of human protein-coding genes, including those responsible for the development and progression of atherosclerosis. Recent studies have shown that platelets contain significant amounts of miRNA that is released into the bloodstream in free form or bound to platelet microparticles. The profile of circulating miRNAs changes in various pathophysiological states, including ACS. The aim of our project is to assess the effect of potent antiplatelet drugs (ticagrelor and prasugrel) on circulating platelet-derived miRNAs, as well as to assess the possibility of using miRNAs in predicting the risk of recurrent ischemic episodes in patients after ACS.