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The Etiology of Atherosclerosis/Coronary Artery Disease

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A special issue of Biology (ISSN 2079-7737).

Deadline for manuscript submissions: closed (15 January 2022) | Viewed by 51834

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Special Issue Editors

Dr. Tomasz Mazurek

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Guest Editor

Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
Interests: atherosclerosis; inflammation; biomarker research; coronary and structural interventions; atrial fibrillation; physical activity

Dr. Aleksandra Gąsecka

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Guest Editor

1. 1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland
2. Laboratory of Experimental Clinical Chemistry, Amsterdam University Medical Centers, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
Interests: biomarker research; antiplatelet therapy; interventional cardiology; cardiovascular imaging; cardiac intensive care
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Miłosz J. Jaguszewski

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First Department of Cardiology, University Catheterization Laboratories, Medical University of Gdansk, Marii Skłodowskiej-Curie 3a, 80-210 Gdańsk, Gdańsk, Poland
Interests: pathophysiology of atherosclerosis; biomarkers; interventional cardiology; invasive imaging; device failure
Special Issues, Collections and Topics in MDPI journals

Prof. Dr. Piotr Zielenkiewicz

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1. Institute of Biochemistry and Biophysics, Polish Academy of Sciences, Pawinskiego 5a, 02-106 Warsaw, Poland
2. Department of Systems Biology, Institute of Experimental Plant Biology and Biotechnology, University of Warsaw, Miecznikowa 1, 02-096 Warsaw, Poland
Interests: protein structure; bioinformatics; interaction networks; systems medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Despite many years of research conducted in leading scientific centers around the world, diseases of the cardiovascular system, and coronary artery disease in particular, still remain the leading causes of death. A better understanding of the etiology leading to the development of atherosclerosis in coronary arteries, the precise determination of the pathophysiological pathways in these processes, and finding new therapeutic targets could significantly reduce overall cardiovascular mortality.

Dear Colleagues,

(1) The general focus of this Special Issue is atherosclerosis, with its pathophysiological specificity. We would like to invite authors to contribute their original research and review papers dealing with bench-to-bedside research on coronary artery disease, acute coronary syndromes, and intensive care, as well as basic research focused on the causes and pathways of atherosclerosis. We also invite researchers dealing with atherosclerotic problems and complications in the era of COVID-19 pandemic to submit their work. Learning about common inflammatory pathways may help us to understand the complicated and multilevel processes leading to coronary atherosclerosis.

(2) Coronary artery disease and especially acute coronary syndromes remain the main cause of deaths in many societies. We hope to address urgent demographic problems leading to the deterioration of quality of life and death, which remains unsolved despite numerous attempts and a tremendous amount of research.

Dr. Tomasz Mazurek
Dr. Aleksandra Gąsecka
Prof. Dr. Miłosz J. Jaguszewski
Prof. Dr. Piotr Zielenkiewicz
Guest Editors

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Keywords

atherosclerosis
coronary artery disease
inflammation
biomarkers

Published Papers (12 papers)

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12 pages, 1177 KiB

Open AccessArticle

Influence of Apnea Hypopnea Index and the Degree of Airflow Limitation on Endothelial Function in Patients Undergoing Diagnostic Coronary Angiography

by Dorota Ochijewicz, Adam Rdzanek, Tadeusz Przybyłowski, Renata Rubinsztajn, Monika Budnik, Ewa Pędzich, Katarzyna Białek-Gosk, Piotr Bielicki and Agnieszka Kapłon-Cieślicka

Biology 2022, 11(3), 457; https://doi.org/10.3390/biology11030457 - 17 Mar 2022

Cited by 2 | Viewed by 1910

Abstract

Background: Obstructive sleep apnea is associated with an increased prevalence of cardiovascular disease. The mechanism of these associations is not completely understood. We aimed to investigate the association of the apnea hypopnea index and the degree of airflow limitation with endothelial dysfunction. Methods: This was a single-center prospective study of patients admitted for diagnostic coronary angiography (CAG). Endothelial function was assessed by the non-invasive EndoPAT system by reactive hyperemia index (RHI) and divided into two groups: endothelial dysfunction and normal endothelial function. Sleep apnea signs were detected by WatchPAT measuring the respiratory disturbance index (pRDI), the apnea and hypopnea index (pAHI), and the oxygen desaturation index (ODI). Patients underwent spirometry and body plethysmography. Based on CAG, the severity of coronary artery disease was assessed as follows: no significant coronary artery disease, single-, two- and three-vessel disease. Results: A total of 113 patients were included in the study. Breathing disorders measured by WatchPAT and spirometry were more severe in patients with endothelial dysfunction: pRDI (27.3 vs. 14.8, p = 0.001), pAHI (24.6 vs. 10.3, p < 0.001), ODI (13.7 vs. 5.2, p = 0.002), forced expiratory volume in one second (FEV₁) (81.2 vs. 89, p = 0.05). In a multivariate regression analysis, pAHI and FEV₁ were independent predictors of endothelial dysfunction assessed by RHI. There was no correlation between the severity of coronary artery disease and endothelial dysfunction. Conclusions: Obstructive sleep apnea signs and greater airflow limitation were associated with endothelial dysfunction regardless of the severity of the coronary artery disease. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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14 pages, 2030 KiB

Open AccessArticle

Ischemic Cardiomyopathy versus Non-Ischemic Dilated Cardiomyopathy in Patients with Reduced Ejection Fraction— Clinical Characteristics and Prognosis Depending on Heart Failure Etiology (Data from European Society of Cardiology Heart Failure Registries)

by Agata Tymińska, Krzysztof Ozierański, Paweł Balsam, Cezary Maciejewski, Anna Wancerz, Emil Brociek, Michał Marchel, Maria G. Crespo-Leiro, Aldo P. Maggioni, Jarosław Drożdż, Grzegorz Opolski, Marcin Grabowski and Agnieszka Kapłon-Cieślicka

Biology 2022, 11(2), 341; https://doi.org/10.3390/biology11020341 - 21 Feb 2022

Cited by 16 | Viewed by 5133

Abstract

Personalized management involving heart failure (HF) etiology is crucial for better prognoses for HF patients. This study aimed to compare patients with ischemic cardiomyopathy (ICM) and patients with non-ischemic dilated cardiomyopathy (NIDCM) in terms of baseline characteristics and prognosis. We assessed 895 patients with HF with reduced left ventricular ejection fraction participating in the Polish part of the European Society of Cardiology (ESC)-HF registries. ICM was present in 583 patients (65%), NIDCM in 312 patients (35%). The ICM patients were older (p < 0.001) and had more comorbidities. The NIDCM patients more frequently had atrial fibrillation (p = 0.04) and lower LVEF (p = 0.01); therefore, they were treated more often with anticoagulants (p = 0.01) and digitalis (p < 0.001). The NIDCM patients were prescribed aldosterone antagonists more often (p = 0.01). There were no other differences as regards the use of HF guideline-recommended medications, implantable cardioverter defibrillators or cardiac resynchronization therapy. The ICM patients were more likely to be treated with statins (p < 0.001) and antiplatelet agents (p < 0.001). All-cause death, as well as all-cause death and readmissions for HF at 12 months, occurred more often in the ICM group compared with the NIDCM group (15.9% vs. 10%, p = 0.016; and 40.9% vs. 28.6%, p = 0.00089, respectively). ICM etiology was an independent predictor of the composite endpoint in the total cohort (p = 0.003). The ICM patients were older and had more comorbidities, whereas the NIDCM patients had lower LVEF. One-year prognosis was worse in the ICM patients than in the NIDCM patients. ICM etiology was independently associated with a worse one-year outcome. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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11 pages, 2349 KiB

Open AccessArticle

Effect of Coronary Artery Disease on COVID-19—Prognosis and Risk Assessment: A Systematic Review and Meta-Analysis

by Lukasz Szarpak, Malgorzata Mierzejewska, Jonasz Jurek, Anna Kochanowska, Aleksandra Gasecka, Zenon Truszewski, Michal Pruc, Natasza Blek, Zubaid Rafique, Krzysztof J. Filipiak, Andrea Denegri and Milosz J. Jaguszewski

Biology 2022, 11(2), 221; https://doi.org/10.3390/biology11020221 - 29 Jan 2022

Cited by 22 | Viewed by 3785

Abstract

Coronary artery disease (CAD) is the leading cause of death worldwide. Patients with pre-existing CAD were shown to have a more severe course of COVID-19, but this association has not been clarified. We performed a meta-analysis to determine the association between CAD and COVID-19 outcomes. We searched Scopus, Medline (PubMed), Web of Science, Embase, and Cochrane databases up to 2 November 2021. There were 62 studies with a total population of 49,286 patients included in the meta-analysis. CAD occurrence in survivor vs. non-survivor groups varied and amounted to 9.2% vs. 22.9%, respectively (OR = 0.33; 95%CI: 0.29 to 0.39; I² = 70%; p < 0.001). CAD was also associated with increased severity of COVID-19 disease and was (10.8% vs. 5.6%, respectively, for severe vs. non-severe groups (OR = 2.28; 95%CI: 1.59 to 3.27; I² = 72%; p < 0.001). The role of history of CAD in mortality and severe condition in COVID-19 presents itself as prominent—although a risk of bias in retrospective trials needs to be assessed, in case of our meta-analysis the statistically significant results when it comes to higher mortality among patients with CAD compared to non-CAD patients, a more severe condition observed in patients with CAD, and a visibly more frequent admission to intensive care unit in patients with CAD, it seems that an incidence of cardiovascular events plays a role in COVID-19 prognosis. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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17 pages, 1936 KiB

Open AccessArticle

The Prognostic Significance of Neutrophil to Lymphocyte Ratio (NLR), Monocyte to Lymphocyte Ratio (MLR) and Platelet to Lymphocyte Ratio (PLR) on Long-Term Survival in Off-Pump Coronary Artery Bypass Grafting (OPCAB) Procedures

by Tomasz Urbanowicz, Anna Olasińska-Wiśniewska, Michał Michalak, Michał Rodzki, Anna Witkowska, Ewa Straburzyńska-Migaj, Bartłomiej Perek and Marek Jemielity

Biology 2022, 11(1), 34; https://doi.org/10.3390/biology11010034 - 27 Dec 2021

Cited by 36 | Viewed by 3397

Abstract

Background: Cardiovascular diseases, apart from commonly known risk factors, are related to inflammation. There are several simple novel markers proposed to present the relation between inflammatory reactions activation and atherosclerotic changes. They are easily available from whole blood count and include neutrophil to lymphocyte ratio (NLR), monocyte to lymphocyte ratio (MLR), and platelets to lymphocyte ratio (PLR). The RDW results were excluded from the analysis. Method and results: The study based on retrospective single-centre analysis of 682 consecutive patients (131 (19%) females and 551 (81%) males) with median age of 66 years (60–71) who underwent off-pump coronary artery bypass grafting (OPCAB) procedure. During the median 5.3 +/− 1.9 years follow-up, there was a 87% cumulative survival rate. The laboratory parameters including preoperative MLR > 0.2 (HR 2.46, 95% CI 1.33–4.55, p = 0.004) and postoperative NLR > 3.5 (HR 1.75, 95% CI 1.09–2.79, p = 0.019) were found significant for long-term mortality prediction in multivariable analysis. Conclusion: Hematological indices NLR and MLR can be regarded as significant predictors of all-cause long-term mortality after OPCAB revascularization. Multivariable analysis revealed preoperative values of MLR > 0.2 and postoperative values of NLR > 3.5 as simple, reliable factors which may be applied into clinical practice for meticulous postoperative monitoring of patients in higher risk of worse prognosis. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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6 pages, 565 KiB

Open AccessCommunication

Immune Checkpoint Inhibitor Therapy Induces Inflammatory Activity in the Large Arteries of Lymphoma Patients under 50 Years of Age

by Raffaella Calabretta, Philipp B. Staber, Christoph Kornauth, Xia Lu, Patrick Binder, Verena Pichler, Markus Mitterhauser, Alexander Haug, Xiang Li and Marcus Hacker

Biology 2021, 10(11), 1206; https://doi.org/10.3390/biology10111206 - 19 Nov 2021

Cited by 3 | Viewed by 1884

Abstract

Background: Immune checkpoint inhibitors (ICI) have transformed the management of various cancers. Serious and potentially fatal cardiovascular toxicity, as well as a progression of atherosclerosis, have been described, mainly in elderly and comorbid patients. Methods: We investigated 117 arterial segments of 12 young (under 50 years of age), otherwise healthy lymphoma patients pre/post-ICI treatment using 2-[18F]fluorodeoxyglucose (FDG) positron emission tomography (PET). Maximum FDG standardized uptake values (SUV_max) and target-to-background ratios (TBRs) were calculated along arterial segments. Additionally, metabolic activities (SUV_max) of the bone marrow, spleen, and liver were analyzed. The levels of high-sensitivity C-reactive protein (hsCRP) were assessed. Results: ICI therapy induced arterial inflammatory activity, detected by increased TBR in arterial segments without pre-existing inflammation (TBRneg_pre = 1.20 ± 0.22 vs. TBRneg_post = 1.71 ± 0.45, p < 0.001), whereas already-inflamed lesions remained unchanged. Dormant calcified segments (Hounsfield Units-HU ≥ 130) showed a significant increase in TBR values after ICI treatment (TBRcalc_pre = 1.36 ± 0.38 vs. TBRcalc_post = 1.76 ± 0.42, p < 0.001). FDG uptake measured in other organs and hsCRP levels remained unchanged after ICI therapy. Conclusions: Although the effects of ICI therapy on arterial inflammation are still incompletely understood, cancer immunotherapy might be a critical moderator of atherosclerosis with a subsequently increased risk of future cerebro- and/or cardiovascular events in young oncological patients. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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12 pages, 608 KiB

Open AccessFeature PaperArticle

Serum Level of Vitamin D Is Associated with Severity of Coronary Atherosclerosis in Postmenopausal Women

by Ewelina Anna Dziedzic, Wiktor Smyk, Izabela Sowińska, Marek Dąbrowski and Piotr Jankowski

Biology 2021, 10(11), 1139; https://doi.org/10.3390/biology10111139 - 05 Nov 2021

Cited by 5 | Viewed by 1792

Abstract

Background: Postmenopausal women experience rapid progression of coronary artery disease. Vitamin D deficiency appears to be a modifiable risk factor for cardiovascular diseases. This study aimed to analyze the impact of 25-hydroxyvitamin D3 (25(OH)D) level on the severity of coronary atherosclerosis and its potential cardioprotective effect in postmenopausal women. Material and Methods: The study prospectively recruited 351 women in postmenopausal age undergoing coronary angiography. The severity of coronary atherosclerosis was assessed using the Coronary Artery Surgery Study Score (CASSS). A level of 25(OH)D was measured with electrochemiluminescence. Results: Women with more severe coronary atherosclerosis have significantly lower 25(OH)D serum level (p = 0.0001). Vitamin D (β = −0.02; p = 0.016), hypertension (β = 0.44; p = 0.025), age (β = 0.02; p = 0.003), and history of MI (β = 0.63; p < 0.0001), were shown as CASSS determinants. Age, hyperlipidemia, and history of MI were found to determine the level of vitamin D (all p < 0.05). Women with a three-vessel disease hospitalized due to ACS, with a history of MI, hyperlipidemia and hypertension presented the lowest vitamin D level. Conclusions: Our study showed that lower serum 25(OH)D in postmenopausal women is associated with more significant stenosis in the coronary arteries. Therefore, we suggest considering low vitamin D level as a potential risk factor for coronary artery disease. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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Review

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24 pages, 2742 KiB

Open AccessReview

Role of Epicardial Adipose Tissue in Cardiovascular Diseases: A Review

by Michał Konwerski, Aleksandra Gąsecka, Grzegorz Opolski, Marcin Grabowski and Tomasz Mazurek

Biology 2022, 11(3), 355; https://doi.org/10.3390/biology11030355 - 23 Feb 2022

Cited by 31 | Viewed by 7673

Abstract

Cardiovascular diseases (CVDs) are the leading causes of death worldwide. Epicardial adipose tissue (EAT) is defined as a fat depot localized between the myocardial surface and the visceral layer of the pericardium and is a type of visceral fat. EAT is one of the most important risk factors for atherosclerosis and cardiovascular events and a promising new therapeutic target in CVDs. In health conditions, EAT has a protective function, including protection against hypothermia or mechanical stress, providing myocardial energy supply from free fatty acid and release of adiponectin. In patients with obesity, metabolic syndrome, or diabetes mellitus, EAT becomes a deleterious tissue promoting the development of CVDs. Previously, we showed an adverse modulation of gene expression in pericoronary adipose tissue in patients with coronary artery disease (CAD). Here, we summarize the currently available evidence regarding the role of EAT in the development of CVDs, including CAD, heart failure, and atrial fibrillation. Due to the rapid development of the COVID-19 pandemic, we also discuss data regarding the association between EAT and the course of COVID-19. Finally, we present the potential therapeutic possibilities aiming at modifying EAT’s function. The development of novel therapies specifically targeting EAT could revolutionize the prognosis in CVDs. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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26 pages, 947 KiB

Open AccessReview

Gastrointestinal Incretins—Glucose-Dependent Insulinotropic Polypeptide (GIP) and Glucagon-like Peptide-1 (GLP-1) beyond Pleiotropic Physiological Effects Are Involved in Pathophysiology of Atherosclerosis and Coronary Artery Disease—State of the Art

by Szymon Jonik, Michał Marchel, Marcin Grabowski, Grzegorz Opolski and Tomasz Mazurek

Biology 2022, 11(2), 288; https://doi.org/10.3390/biology11020288 - 11 Feb 2022

Cited by 11 | Viewed by 6613

Abstract

Coronary artery disease (CAD), which is the manifestation of atherosclerosis in coronary arteries, is the most common single cause of death and is responsible for disabilities of millions of people worldwide. Despite numerous dedicated clinical studies and an enormous effort to develop diagnostic and therapeutic methods, coronary atherosclerosis remains one of the most serious medical problems of the modern world. Hence, new markers are still being sought to identify and manage CAD optimally. Trying to face this problem, we have raised the question of the most predominant gastrointestinal hormones; glucose-dependent insulinotropic polypeptide (GIP) and glucagon-like peptide-1 (GLP-1), mainly involved in carbohydrates disorders, could be also used as new markers of incidence, clinical course, and recurrence of CAD and are related to extent and severity of atherosclerosis and myocardial ischemia. We describe GIP and GLP-1 as expressed in many animal and human tissues, known to be connected to inflammation and related to enormous noncardiac and cardiovascular (CV) diseases. In animals, GIP and GLP-1 improve endothelial function and lead to reduced atherosclerotic plaque macrophage infiltration and stabilize atherosclerotic lesions by directly blocking monocyte migration. Moreover, in humans, GIPR activation induces the pro-atherosclerotic factors ET-1 (endothelin-1) and OPN (osteopontin) but also has anti-atherosclerotic effects through secretion of NO (nitric oxide). Furthermore, four large clinical trials showed a significant reduction in composite of CV death, MI, and stroke in long-term follow-up using GLP-1 analogs for DM 2 patients: liraglutide in LEADER, semaglutide in SUSTAIN-6, dulaglutide in REWIND and albiglutide in HARMONY. However, very little is known about GIP metabolism in the acute phase of myocardial ischemia or for stable patients with CAD, which constitutes a direction for future research. This review aims to comprehensively discuss the impact of GIP and GLP-1 on atherosclerosis and CAD and its potential therapeutic implications. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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20 pages, 11385 KiB

Open AccessReview

Unexpected Relationships: Periodontal Diseases: Atherosclerosis–Plaque Destabilization? From the Teeth to a Coronary Event

by Maciej R. Czerniuk, Stanisław Surma, Monika Romańczyk, Jacek M. Nowak, Andrzej Wojtowicz and Krzysztof J. Filipiak

Biology 2022, 11(2), 272; https://doi.org/10.3390/biology11020272 - 09 Feb 2022

Cited by 19 | Viewed by 6838

Abstract

Atherosclerotic cardiovascular disease (ASCVD) and periodontal disease (PD) are global health problems. High frequency of ASCVD is associated with the spread of many risk factors, including poor diet, sedentary lifestyle, diabetes, hyperlipidemia, obesity, smoking, hypertension, chronic kidney disease, hypertension, hyperhomocysteinemia, hyperuricemia, excessive stress, virus infection, genetic predisposition, etc. The pathogenesis of ASCVD is complex, while inflammation plays an important role. PD is a chronic, multifactorial inflammatory disease caused by dysbiosis of the oral microbiota, causing the progressive destruction of the bone and periodontal tissues surrounding the teeth. The main etiological factor of PD is the bacteria, which are capable of activating the immune response of the host inducing an inflammatory response. PD is associated with a mixed microbiota, with the evident predominance of anaerobic bacteria and microaerophilic. The “red complex” is an aggregate of three oral bacteria: Tannerella forsythia Treponema denticola and Porphyromonas gingivalis responsible for severe clinical manifestation of PD. ASCVD and PD share a number of risk factors, and it is difficult to establish a causal relationship between these diseases. The influence of PD on ASCVD should be treated as a factor increasing the risk of atherosclerotic plaque destabilization and cardiovascular events. The results of observational studies indicate that PD significantly increases the risk of ASCVD. In interventional studies, PD treatment was found to have a beneficial effect in the prevention and control of ASCVD. This comprehensive review summarizes the current knowledge of the relationship between PD and ASCVD. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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30 pages, 1360 KiB

Open AccessReview

Platelet–Leucocyte Aggregates as Novel Biomarkers in Cardiovascular Diseases

by Kinga Pluta, Kinga Porębska, Tomasz Urbanowicz, Aleksandra Gąsecka, Anna Olasińska-Wiśniewska, Radosław Targoński, Aleksandra Krasińska, Krzysztof J. Filipiak, Marek Jemielity and Zbigniew Krasiński

Biology 2022, 11(2), 224; https://doi.org/10.3390/biology11020224 - 30 Jan 2022

Cited by 15 | Viewed by 5316 | Correction

Abstract

Platelet–leucocyte aggregates (PLA) are a formation of leucocytes and platelets bound by specific receptors. They arise in the condition of sheer stress, thrombosis, immune reaction, vessel injury, and the activation of leukocytes or platelets. PLA participate in cardiovascular diseases (CVD). Increased levels of PLA were revealed in acute and chronic coronary syndromes, carotid stenosis cardiovascular risk factors. Due to accessible, available, replicable, quick, and low-cost quantifying using flow cytometry, PLA constitute an ideal biomarker for clinical practice. PLA are promising in early diagnosing and estimating prognosis in patients with acute or chronic coronary syndromes treated by percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG). PLA were also a reliable marker of platelet activity for monitoring antiplatelet therapy. PLA consist also targets potential therapies in CVD. All of the above potential clinical applications require further studies to validate methods of assay and proof clinical benefits. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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23 pages, 1554 KiB

Open AccessReview

Diagnostic and Prognostic Value of miRNAs after Coronary Artery Bypass Grafting: A Review

by Ewelina Błażejowska, Tomasz Urbanowicz, Aleksandra Gąsecka, Anna Olasińska-Wiśniewska, Miłosz J. Jaguszewski, Radosław Targoński, Łukasz Szarpak, Krzysztof J. Filipiak, Bartłomiej Perek and Marek Jemielity

Biology 2021, 10(12), 1350; https://doi.org/10.3390/biology10121350 - 19 Dec 2021

Cited by 7 | Viewed by 5179

Abstract

MiRNAs are noncoding, 21–24 nucleotide-long RNA particles that control over 60% of genes. MiRNAs affect gene expression through binding to the 3’-untranslated region of messenger RNA (mRNA), thus inhibiting mRNA translation or inducing mRNA degradation. MiRNAs have been associated with various cardiovascular diseases, including heart failure, hypertension, left ventricular hypertrophy, or ischemic heart disease. In addition, miRNA expression alters during coronary artery bypass grafting (CABG) surgery, which could be used to predict perioperative outcomes. CABG is an operation in which complex coronary arteries stenosis is treated by bypassing atherosclerotic lesions with venous or arterial grafts. Despite a very low perioperative mortality rate and excellent long-term survival, CABG is associated with postoperative complications, including reperfusion injury, graft failure, atrial fibrillation and perioperative myocardial infarction. So far, no reliable diagnostic and prognostic tools to predict prognosis after CABG have been developed. Changes in the perioperative miRNA expression levels could improve the diagnosis of post-CABG myocardial infarction and atrial fibrillation and could be used to stratify risk after CABG. Herein, we describe the expression changes of different subtypes of miRNAs during CABG and review the diagnostic and prognostic utility of miRNAs in patients undergoing CABG. Full article

(This article belongs to the Special Issue The Etiology of Atherosclerosis/Coronary Artery Disease)

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