Evidence map›Paper›PMID 32718726›Full record

Observational studyBritish journal of anaesthesia2020

MicroRNA signatures of perioperative myocardial injury after elective noncardiac surgery: a prospective observational mechanistic cohort study.

Shaun M May, Tom E F Abbott, Ana G Del Arroyo, Anna Reyes, Gladys Martir, Robert C M Stephens, David Brealey, Brian H Cuthbertson, Duminda N Wijeysundera, Rupert M Pearse and 1 more

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in British journal of anaesthesia, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed
2.4field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 37 citations in OpenAlex.

  1. Article
  2. Review
  3. Article
  4. Article
  5. Article
  6. Article
  7. Mechanisms of Post-critical Illness Cardiovascular Disease.Frontiers in cardiovascular medicine · 2022
    Review
  8. Article
  9. The emergence of a postoperative myocardial injury epidemic: true or false?Canadian journal of anaesthesia = Journal canadien d'anesthesie · 2021
    Article
  10. Article
  11. Observational
  12. A bioinformatics approach to microRNA-sequencing analysis.Osteoarthritis and cartilage open · 2021
    Article
  13. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 2 countries.

Shaun M MayTranslational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK.
Tom E F AbbottTranslational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK.
Ana G Del ArroyoTranslational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK.
Anna ReyesUniversity College London NHS Hospitals Trust, London, UK.
Gladys MartirUniversity College London NHS Hospitals Trust, London, UK.
Robert C M StephensUniversity College London NHS Hospitals Trust, London, UK.
David BrealeyUniversity College London NHS Hospitals Trust, London, UK.
Brian H CuthbertsonDepartment of Anaesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada; Department of Critical Care Medicine, Sunnybrook Health Science Centre, Toronto, ON, Canada.
Duminda N WijeysunderaDepartment of Anaesthesiology and Pain Medicine, University of Toronto, Toronto, ON, Canada.
Rupert M PearseTranslational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK.
Gareth L AcklandTranslational Medicine & Therapeutics, William Harvey Research Institute, Queen Mary University of London, London, UK. Electronic address: g.ackland@qmul.ac.uk.
Queen Mary University of London · GBUniversity College London · GBUniversity of Toronto · CAWilliam Harvey Research Institute · GBUniversity College London Hospitals NHS Foundation Trust · GB

Funding

Medical Research Council MR/M017974/1
6 · The paper itself

Abstract

backgroundElevated plasma or serum troponin, indicating perioperative myocardial injury (PMI), is common after noncardiac surgery. However, underlying mechanisms remain unclear. Acute coronary syndrome (ACS) is associated with the early appearance of circulating microRNAs, which regulate post-translational gene expression. We hypothesised that if PMI and ACS share pathophysiological mechanisms, common microRNA signatures should be evident.

methodsWe performed a nested case control study of samples obtained before and after noncardiac surgery from patients enrolled in two prospective observational studies of PMI (postoperative troponin I/T>99th centile). In cohort one, serum microRNAs were compared between patients with or without PMI, matched for age, gender, and comorbidity. Real-time polymerase chain reaction quantified (qRT-PCR) relative microRNA expression (cycle quantification [Cq] threshold <37) before and after surgery for microRNA signatures associated with ACS, blinded to PMI. In cohort two, we analysed (EdgeR) microRNA from plasma extracellular vesicles using next-generation sequencing (Illumina HiSeq 500). microRNA-messenger RNA-function pathway analysis was performed (DIANA miRPath v3.0/TopGO).

resultsMicroRNAs were detectable in all 59 patients (median age 67 yr [61-75]; 42% male), who had similar clinical characteristics independent of developing PMI. In cohort one, serum microRNA expression increased after surgery (mean fold-change) hsa-miR-1-3p: 3.99 (95% confidence interval [CI: 1.95-8.19]; hsa-miR-133-3p: 5.67 [95% CI: 2.94-10.91]; P<0.001). These changes were not associated with PMI. Bioinformatic analysis of differentially expressed microRNAs from cohorts one (n=48) and two (n=11) identified pathways associated with adrenergic stress and calcium dysregulation, rather than ischaemia.

conclusionsCirculating microRNAs associated with cardiac ischaemia were universally elevated in patients after surgery, independent of development of myocardial injury.

Indexed as

Acute Coronary SyndromeAgedCase-Control StudiesChromosome MappingElective Surgical ProceduresExtracellular MatrixFemaleHeart InjuriesHumansMaleMetabolic Networks and PathwaysMicroRNAsMiddle AgedMyocardial IschemiaPostoperative ComplicationsProspective StudiesMicroRNAsmicroRNAnoncardiac surgeryperioperative myocardial injuryperioperative periodpostoperative complications

Identifiers

PMID32718726
PMCPMC7678162
OpenAlexW3045016448

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.