The Exploration Of The Significance And Expression Of Serum MiRNA-29a Pre And Post Endovascular Repair Of Abdominal Aortic Aneurysm

BackgroundAbdominal aortic aneurysm(AAA),defined as 1.5 times greater than normal arterial diameter,is a kind of severe aortic degenerative disease which has a tendency of rupture.It threats human life and health seriously and has an upward trend in the morbidity along with age.As a result of minimal invasive,low perioperative mortality and complication rate,short operation and hospital stay,fast postoperative recovery and other characteristics,endovascular aortic repair has become the first-line therapy for most patients with AAA.However,post-EVAR aneurysmal dilation is the reason for re-intervention.Physical examination was mostly used for AAA follow-up in the past,however in recent years,studies have shown that blood biomarkers may be associated with the development of AAA.Serum miRNA-29a was confirmed to be related to the size of the aneurysm diameter,but there still no report about the relationship between serum miRNA-29a and aneurysm diameter pre and post abdominal aortic aneurysm endovascular repair.ObjectiveTo explore the significance and expression of serum miRNA-29a pre and post endovascular repair of abdominal aortic aneurysmMaterials and methodsFrom Nov 2014 to Dec 2015,60 patients with AAA were divided into two groups:group EVAR and group Observation.Abdominal aortic CTA and relative quantity of serum miRNA-29a in PCR were collected at pre-EVAR and the 3、6、12 month post EVAR.Abdominal aortic CTA and relative quantity of serum miRNA-29a in PCR were collected at outpatient clinic and the 6、12 month thereafter in group Observation.SPSS 18.0 and GraphPad Prism software were used for statistical analysis of the relationship between serum miRNA-29a level and clinical date,a P value<0.05 was considered as statistical significance.Results9 patients were transferred to group EVAR as the increasing diameter of aneurysm at least 5 mm per 6 months.Among 49 AAA patients,there were 5 deaths(2 cases died of respiratory and renal failure during hospitalization and 3 died of acute heart failure in two months post-EVAR).The median follow up duration was 15 months(12-20months),and all the 55 patients were not lost to follow up.Statistical analyze of correlation coefficient between Max diameter of AAA and serum miRNA-29a level in 60 patients was significant(r =-0.600,P<0.05).Statistical significance(P<0.05)was obtained in maximum aneurysm diameter between pre EVAR and the 3,6,12 month post EVAR(5.66 ± 1.00 cm:4.87 ± 1.70 cm:4.12 ± 0.99 cm:3.70 ± 0.89 cm).All of the serum miRNA-29a amplified well and expression of initial serum miRNA-29a(EVAR vs Observation = 19.56 ± 3.83 vs 22.88 ±4.42)between two groups were statistically significant(P<0.05).Statistical significance(P<0.05)was obtained in serum miRNA-29a between pre EVAR and the 3,6,12 month post EVAR(19.56 ± 3.83:20.34 ± 4.73:21.78 ± 4.65:22.92 ± 4.14).Serum miRNA-29a level is negatively related to the aneurysm diameter,the correlation coefficient at pre EVAR and the 3,6,12 month post EVAR is significant(r=-0.508,P<0.05:r =-0.504,P<0.05:r =-0.540,P<0.05:r =-0.503,P<0.05).Statistical difference was obtained between group low expression of serum miRNA-29a and group high expression of serum miRNA-29a in Max diameter of aneurysm and gender(P<0.05),but not in age、hypertension or not、iliac artery involved or not and the twist angle(P>0.05).ConclusionsSerum miRNA-29a level is negatively related to the aneurysm diameter.Gender and aneurysm diameter are related to serum miRNA-29a level,while age、hypertension or not、iliac artery involved or not and the twist angle are not.And serum miRNA-29a may be a potential biomarker for the assessment of aneurysm diameter pre and post EVAR.