Background: Due to their exceptional stability in the circulation, microRNAs (miRs) are
being identified as promising biomarkers. On the other hand, their propensity to regulate networks of
functionally closely related genes and relative ease of delivery makes them attractive targets for therapy.
However, neither application is without challenges, especially as it applies to ischemic coronary
artery disease (CAD).
Objective: This review will: 1) describe miRs which have been most consistently found to be associated
with the most common manifestations of CAD, including atherosclerosis, angina pectoris, myocardial
infarction and myocardial reperfusion through arteriogenesis, 2) emphasize those miRs which
are also altered in metabolic syndrome and its component pathologies, 3) discuss challenges which
currently prevent clinical application related to inconsistencies between findings in cell culture, animal
models and among human studies, as well as technical challenges, and 4) offer some suggestions towards
resolutions of these discrepancies.
Conclusion: While miRs can be used as reliable biomarkers for myocardial infarction, their use as
biomarkers for other forms of ischemic CAD, as well as therapy for CAD await further investigation.