| Objective:As the most serious ischemic heart disease,acute myocardial infarction(AMI)remains has a high morbidity and mortality worldwide,especially in rural areas.At present,early diagnosis and reperfusion therapy of AMI are the most crucial measures to reduce the mortality of this disease.Therefore,early and timely diagnosis of AMI is of great significance for guiding clinical work.Recently,studies on the potential value of non-coding RNA in cardiovascular diseases(CAD)have attracted much attention.We aimed to investigate the expression levels and clinical significance of circulating miRNAs in the early stage of AMI,and explored whether they can be used as novel markers in clinical practice.Methods:The study included 40 AMI patients as the experimental group.All AMI patients underwent percutaneous coronary intervention(PCI).Non-myocardial infarction(Non-MI)patients were enrolled as control group in the same period,including 22 unstable angina pectoris(UAP)patients and 22 healthy controls(HC).The expression levels of miR-486-5p,miR-451 a and miR-21-5p were measured by real-time fluorescence quantitative polymerase chain reaction(q PCR),and their expression among different groups(AMI,UAP and HC)were compared,while various clinical basic data and routine results were collected for analysis.Results:1 The expression difference of miR-486-5p,miR-451 a and miR-21-5pThrough relevant data,it was found that the expression level of plasma miR-451 a was significantly higher in AMI patients than those Non-MI patients(P<0.001),while the expression of miR-486-5p and miR-21-5p were reduced(P<0.05,P<0.001).MiR-451a and miR-21-5p showed significant differences among the three groups(AMI,UAP and HC).Unfortunately,miR-486-5p,miR-451a and miR-21-5p had no statistical differences after PCI in AMI patients compared with admission(before PCI)(P>0.05),but after undergoing PCI,miR-451a and miR-21-5p showed statistical significance compared with the HC(P<0.001,P<0.01).2 Analysis of the sensitivity and specificity of miR-486-5p,miR-451a and miR-21-5pReceiver operating characteristic(ROC)showed that the area under the curve(AUC)of miR-486-5p,miR-451 a and miR-21-5p at admission for AMI patients were 0.669(95%CI:0.538～0.783),0.823(95%CI: 0.706～0.908)and0.660(95%CI:0.529～0.776),respectively.When the expression of miR-486-5p,miR-451 a and miR-21-5p were 0.065,0.062 and 0.026,respectively,the sensitivity for diagnosing AMI was 59.1%,82.5% and 82.5%,and specificity was 70.0%,81.8% and 45.5%,respectively.The combination of detection significantly improved the diagnostic efficacy(0.893,95%CI: 0.817～0.969).The AUC of miR-451 a and miR-21-5p after PCI in AMI patients were0.808(95%CI:0.697～0.919),0.674(95%CI:0.539～0.808),respectively,the combination of the AUC was 0.820(95 %CI:0.702～0.906).3 Correlation analysisThe expression levels of miR-486-5p,miR-451 a and miR-21-5p showed the correlation with CK-MB.The expression of miR-21-5p showed negative correlation with c Tn I(r =-0.411,P< 0.01).Moreover,we found that the expression of miR-486-5p and miR-21-5p showed positive correlation(r =0.417,P< 0.001).4 Logistic regressionUnivariate analysis showed that miR-451 a and miR-21-5p may be independent predictors of early AMI.In the multivariate logistic regression model,miR-451 a and miR-21-5p could still predict the occurrence of AMI(P<0.05).Conclusion:1 MiR-486-5p,miR-451 a and miR-21-5p play important roles in AMI and are potential biomarkers of early AMI,in which miR-451 a has better diagnostic value.2 The combined detection of miR-486-5p,miR-451 a and miR-21-5p may improve the efficacy of early diagnosis of AMI,indicating that the combination of detection has high clinical value.3 MiR-451 a and miR-21-5p are independent predictors of AMI,and they will provide the research basis for the second generation of diagnostic markers and new target of molecular for AMI. |
PDF Full Text Request