Plasma miR-148b-3p is associated with CKD-related renal dysfunction and carotid plaque burden in patients with established coronary artery disease.

Background: Chronic kidney disease (CKD) is associated with increased atherosclerotic burden and vascular risk, particularly in patients with established coronary artery disease (CAD). Circulating microRNAs may reflect renal dysfunction and systemic vascular injury. We investigated whether plasma miR-148b-3p is associated with renal function and carotid plaque burden in patients with established CAD. Methods: We conducted a single-center cross-sectional study of 190 hospitalized patients with coronary artery disease, including 90 with CKD and 100 without CKD. Plasma miR-148b-3p was measured by quantitative polymerase chain reaction. Carotid atherosclerosis was assessed by ultrasonography and quantified by Crouse score. Associations with renal function and plaque burden were evaluated using correlation analysis, multivariable regression, restricted cubic spline analysis, ROC analysis, bootstrap validation, and incremental predictive analyses. Bioinformatic and transcriptomic analyses were performed to identify hypothesis-generating candidate targets. Results: In patients with established CAD, plasma miR-148b-3p levels were higher in CKD than non-CKD patients [8.77 (7.35, 11.08) vs. 2.43 (1.41, 3.45), Conclusions: In patients with established CAD, plasma miR-148b-3p was associated with CKD status, impaired renal function, and carotid plaque burden. Its potential adjunctive value for plaque assessment remains exploratory and requires confirmation in larger prospective cohorts with independent external validation.