Value Of MicroRNA-92a For Risk Stratification And Prognosis In The Early Stage Onset Of ST-segment Elevation Myocardial Infarction

Objective: To analyze the relativity of peripheral circulating micro RNA-92 a with gensini score and TIMI risk score in the early stage onset of ST-segment elevation myocardial infarction.To explore the value of micro RNA-92 a for risk stratification and prognosis in the early stage onset of ST-segment Elevation myocardial Infarction.Methods:Successfully treated by emergency coronary revascularization of 60 acute patients STEMI onset within 12 hours were selected from April 2014 to May 2015 in the People’s Hospital of Guangxi Zhuang Autonomous Region.They were evaluated with TIMI risk score based on medical history and emergency hospital condition.At the same time extraction 5ml venous blood supply scientific experimental center to test micro RNA-92 a.Then they were evaluated with Gensini score based on emergency coronary angiography.Collected all patients’ clinical test data and cardiovascular events.By fluorescence quantitative RT-PCR raw,using theautomatic analysis system to get the CT value of micro RNA-92 a and U6,the average of two replicates,micro RNA-92 a expression by 2-△CTformula.During onset within 6 months,through outpatients visits or by telephone to follow-up cardiovascular events of all patients.Results:1.The expression level of micro RNA-92 a and the severity of coronary artery lesionscore Gensini score correlation coefficient was 0.657(P=0.00).2.The expression level of micro RNA-92 a had no differences in different time period within 12 hours of STEMI.3.By TIMI risk score stratification,the expression level of micro RNA-92 a in low-risk group(0~3score)were higher than middle high-risk group(4~14score)(136.27±94.6VS441.28±195.98),the difference was statistically significant(P=0.00).The expression level of micro RNA-92 a and TIMI risk score correlation coefficient was 0.751(P=0.00).4.The results by ROC showed micro RNA-92a(AUC 0.84,95%CI 0.723~0.922,P=0.00).When the expression level was 193.07,micro RNA-92 a predicted optimal cut off of cardiovascular events’ sensibility was 0.778,specificity was 0.833,the Youden index was 0.611.Cardiovascular events incidence rate in the lower expression group was lower than the higher expression group(27.27%vs78.95%),the difference was statistically significant(P=0.00).5.The results by ROC showed TIMI risk score(AUC 0.807,95% CI 0.684~0.897,P=0.00).When the score was 3.5,TIMI risk score predicted optimal cut off of cardiovascular events’ sensibility was 0.611,specificity was 0.875,the Youden index was 0.486.6.The ratio by OR micro RNA-92 a and electrocardiogram(2.981/1.600),to determine micro RNA-92 a in the new TIMI risk score of score of 2 point.7.The addition of micro RNA-92 a to the TIMI risk score improve its prognostic value(AUC 0.864,95% CI 0751~0.939,P =0.00),when the score was 3.5,TIMI risk score predicted optimal cut off of cardiovascular events’ the sensibility was 0.805,the specificity was 0.750,the Youden index was3.5.The difference was statistically significant by paired t-test,(Z=2.515,P=0.01).Conclusion: 1.The expression level of micro RNA-92 a with coronary artery lesion score has a reliable correlation in the early onset of acute ST-segment elevation.The expression level of micro RNA-92 a is higher,the more severe coronary lesions.2.The expression level of micro RNA-92 a is higher,the more dangerous of acute ST-segment elevation patients,it’s valuable to make personalized treatment plan.3.The expression level of micro RNA-92 a is higher to patients with cardiovascular events,micro RNA-92 a is helpful to predict the prognosis of acute ST-segment elevation patients in both hospitalization and follow-up for six months.4.micro RNA-92 a can add the prognostic value of TIMI risk score for cardiovascular events rate of STEMI patients both hospitalization and followup for six months.