The relationship between MicroRNA-21 expression, cardiac biomarkers and some cytokines in cardiovascular diseases

الملخص

Cardiovascular diseases (CVDs) are the leading cause of death worldwide and miR-21 is involved in regulating a complex network of metabolic, inflammatory, and molecular pathways in apoptosis, fibrosis, and cardiac remodeling. The aim of this study was to assess the association of MicroRNA-21 expression with cardiac markers (troponin and creatin kinase) and selected inflammatory cytokines in patients suffering from cardiovascular diseases. This is a case-control study that included 137 patients with cardiovascular diseases who were collected from the Al-Zahraa Teaching Hospital in Wasit, City in Iraq in the period from January 2025 to December 2025 in addition to 100 healthy controls. For biochemical and molecular analyses, 5 mL of venous blood samples were taken aseptically within three days of the onset of cardiac symptoms. The results of the present study, which included 137 cardiovascular disease patients and 100 healthy controls, showed that 78.8% of the patients were males and 21.2% were females. The majority of patients were aged 56–65 years (51.8%), followed by 66–75 years (31.4%). Regarding body mass index, 52.6% of patients were classified as overweight (25–30 kg/m²) and 37.2% as obese (30–35 kg/m²). Biochemical analysis revealed a marked elevation in Troponin T levels in patients (37.15 ± 4.28 pg/mL) compared to controls (5.12 ± 0.64 pg/mL), as well as CK-MB levels (4.06 ± 0.67 ng/mL vs. 0.08 ± 0.03 ng/mL, respectively). Inflammatory cytokines showed increased IL-6 (25.49 ± 0.52 ng/L) and IL-12 (29.46 ± 1.07 pg/mL) alongside decreased IL-10 levels (5.22 ± 0.81 pg/mL) compared with controls (19.64 ± 2.45 pg/mL). Furthermore, miR-21 expression was significantly upregulated in patients (2.459-fold) compared with controls (1.019-fold), demonstrating strong diagnostic performance with an AUC of 0.942, sensitivity of 91.2%, and specificity of 94.0%, indicating its potential as a promising molecular biomarker in cardiovascular diseases.This study suggests that the increase in miR-21 is correlated with cardiac biomarker and inflammatory cytokine alteration, therefore may be a significant clinical and pathophysiological marker in cardiovascular disease.