When you visit your general practitioner you can get your blood analyzed for cholesterol and triglycerides, to get an idea of your risk for cardiovascular disease. With additional information about BMI, smoking habits and blood pressure, this can be used to calculate your 10-year risk for cardiovascular disease. There are several risk prediction calculators available today that general practitioners can use the before they give advice and prescriptions to their patients. This risk calculators predicts the 10-year risk for dying form cardiovascular disease, and includes information on age, gender, smoking habits, systolic blood pressure and total cholesterol.
However, the use of risk prediction calculators has declined in the primary care setting because the currently available calculators only explain a modest proportion of the incidence. For myocardial infarction, it is estimated that 15–20% of the patients had none of the traditional risk factors and would be classified as “low risk”. There have been several attempts during the last years to improve the risk prediction calculators by adding new biomarkers. Some calculators add information of an inflammation marker in blood called CRP (C-reactive protein) or a diabetic marker called HbA1c (glycosylated hemoglobin). This increases the accuracy of the calculators, but still there is a need for new cardiovascular biomarkers that could complement the assessment of traditional risk factors, to identify the individuals at risk with greater precision than today.
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Based on this, we designed a study to explore the possibility of a new type of biomarker called circulating microRNAs, to predict 10-year risk for myocardial infarction. We included 212 healthy participants (40–70 years) from the Nord-Trøndelag Health Study 2 (HUNT2, blood collected in 1996) that either died from myocardial infarction within 10 years or remained healthy at the time of HUNT3 (2006). 179 different microRNAs were quantified in blood samples from these participants. The results showed that by measuring a combination of five different microRNAs and adding this information to the traditional risk factors for cardiovascular disease, we could identify those that were going to experience a myocardial infarction with considerably improved precision. The study was approved for publication in the Level-2 journal, JMCC (Journal of Molecular and Cellular Cardiology) on May 13th 2016. Colleagues at the University of Oslo and the Dept. of Public Health and General Practice (NTNU) have been important collaborators for this study.
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For all biomarker studies, replication of the results in new studies is essential to determine the strength of the biomarkers, and to evaluate the potential use in a clinical setting. This is why we have initiated a new study, in collaboration with Karolinska Institutet, to further test these microRNAs in new participants from the HUNT study. Two medical students from CERG will work on this study during the autumn, and we expect to have the new results ready for publication in January 2017.
Anja Bye, Researcher at CERG