Circulating microRNAs to predict heart failure after acute myocardial infarction in women

Left ventricular remodeling after acute myocardial infarction affects cardiac function and increases the risk of developing heart failure. Despite the emergence of biomarkers associated with remodeling, the ideal biomarker to accurately predict the risk of developing heart failure after acute myocardial infarction is still to be discovered. Female and male hearts cope differently with ischemic stress, leading to different consequences on cardiac morphology and function. As biomarkers reflect the pathogenesis of remodeling, utilization of sex-specific biomarkers might improve risk stratification. Expressed in cardiac and inflammatory cells, microRNAs regulate several biological pathways triggering the remodeling process. In addition, circulating microRNAs are associated with the risk of developing heart failure after acute myocardial infarction, hence their biomarker potential. Interestingly, multiple microRNAs display sex-specific expression profiles as they can be modulated by sexual hormones and escape X-inactivation, for those located on the X-chromosome. This review article aims to discuss the potential of circulating microRNAs to predict heart failure after acute myocardial infarction in a sex-specific manner.