| Objective: To explore the difference of plasma micro RNA(mi RNA) content in patients with coronary heart disease and the subjects without coronary artery lesions. To investigate the relationship between micro RNA and coronary heart disease, the clinical index of experimental examination and the severity of coronary lesions. To explore the relationship between mi RNA and MACE events occurred after stenting and its clinical significance.Methods: This study selected 156 patients who underwent coronary artery CT or coronary angiography in May of 2013 to May of 2014 from Tianjin Thoracic hospital. 102 patients were male, 54 female, age(58.9 ± 8.0) years old.The coronary heart disease(CHD) patients(observation group, 120 cases) and non coronary heart disease(Non-CHD) patients(control group, 36 cases).Patients with coronary disease were divided into angina(AP) subgroup(69 cases) and acute myocardial infarction(AMI)subgroup(51 cases). Peripheral blood from the patients was obtained, the total RNA was extracted,the contents of mi RNA-21, mi RNA-1 and mi RNA-133 were detected by using real-time fluorescence quantitative PCR(q RT-PCR).To analyze the different expression of mi RNA in each group. And collect all enrolled the biochemical and clinical indexes, angiography. Such as CK-MB, c Tn I, BNP, LVEF, coronary Gensini score and LV value, HCY value, FIB value, etc. And to analyze the relationship between mi RNA and coronary heart disease and the clinical indicators, the severity of coronary artery lesions. Follow up 115 CHD patients after stenting for 12 months, record the occurrence of MACE, including death, repeat revascularization reconstruction, angina, non fatal myocardial infarction. Record the results of follow-up and review of coronary angiography.Results: 一. analysis results of plasma mi RNA content between Non-CHD group and CHD group 1.comparative analysis of the content of plasma mi RNA-21(1) plasma mi RNA-21 of CHD group was significantly higher than that of Non-CHD group(1.105(0.619,3.018) vs 0.970(0.405,1.240),P=0.038).(2)The expression of plasma mi RNA-21 in AMI group was significantly higher than that in control and AP groups(3.110±4.074 vs 0.828±0.440,3.110 ±4.074 vs 1.423±1.046,P<0.05).The relative expression level of plasma mi RNA-21 in AP group is apparently higher than that of control group(1.423±1.046 vs 0.828±0.440, P<0.05). The expression level of plasma mi RNA-21 in AP group was 1.72 times that of in the control group, and AMI group was 3.75 times that of in the control group. 2.comparative analysis of the content of plasma mi RNA-1(1) Compared with the Non-CHD group,the content of plasma mi RNA-1 in CHD group was significantly decreased(0.541(0.495,0.687) vs 0.852(0.671,1.301),P= 0.035).(2) The expression level of plasma mi RNA-1 in AMI group was significantly lower than that in the AP group and control group(0.537±0.097 vs 1.156± 0.955,0.537±0.097 vs 0.906±0.301,P<0.05). 3. comparative analysis of the content of plasma mi RNA-133(1) Compared with the expression level of plasma mi RNA-133 in Non-CHD group,that in CHD group were down regulated obviously(0.130(0.117,0.429) vs 1.461(0.319,2.265), P=0.000).(2)The expression quantity of mi RNA-133 in AMI group and AP group were significantly lower than that of the control group(0.131±0.049 vs 1.500±1.041, 0.791±0.818vs1.500±1.041, P<0.05). The expression quantity of mi RNA-133 in AMI group was significantly lower than in AP group(0.131±0.049 vs 0.791±0.818, P<0.05). 二. The relationship between the plasma mi RNA and the degree of stenosis of coronary artery disease 1. mi RNA-21:(1)The content of plasma mi RNA-21 of 3 coronary vessels disease was significantly higher than that of 1 vessel disease and 2 vessels disease(1.869±1.726 vs 0.825 ±0.712,1.869±1.726 vs 1.032± 1.017, P < 0.05).(2) The expression of Plasma mi RNA-21 in the group of Gensini score >25 scores was significantly higher than that in the control group and 0 < Gensini integral(P<0.05). 2. mi RNA-1(1) There were no statistical difference among the 1 vessel group, 2 vessels group and 3 vessels group in the content of plasma mi RNA-1(P > 0.05).(2) The expression of plasma mi RNA-1 in the group of Gensini score >25 scores was significantly lower than that in 0 < Gensini score ≤ 25 group and control group(P<0.05). 3. mi RNA-133:(1) There were no significant difference among the 1 vessel group, 2 vessels group and 3 vessels group in content of plasma mi RNA-133(P > 0.05).(2) The expression of plasma mi RNA-133 in the group of Gensini score >25 scores and 0 < Gensini score ≤ 25 group were significantly lower than that in the control group(P<0.05). 三.The ROC curve of expression of circulating mi RNA in three patients(1) Area under the ROC curve(AUC) of the expression of plasma mi RNA-21 was0.7941. When the relative expression of mi R-21 was more than 1.521,it was possible to be the best diagnosis point, sensitivity was 79.41% and specificity was 80.77%.(2) AUC of the expression of mi RNA-1 was 0.971. When the relative expression amount of mi RNA-1 was less than 0.588, it was possible to be the best diagnosis point,sensitivity was 97.1% and specificity was 90.0%.(3) AUC of the expression of mi RNA-133 was 0.990. When the relative expression amount of mi RNA-133 less than 0.253, it maybe the best diagnosis point,sensitivity was 96.9% and specificity was 93.7%. 四. The results of Spearman correlation analysis of different mi RNA in plasma and other laboratory indicators(1) The expression of plasma mi RNA-21 in plasma was positively correlated with c Tn I and K-MB.(2) The expression of plasma mi RNA-133 was negatively correlated with CK, CK-MB, c Tn I, WBC and CRP.(3) The expression of plasma mi RNA-1 was negatively correlated with CK, CK-MB and CRP. 五. Risk factors of CHD by Logistic regression analysis Gender, age, smoking, LP(a), history of hypertension are risk factors of CHD. mi RNA-133 is a protective factor.六.Cox multivariate regression analysis on the case of MACE after coronary stenting results Gensini, mi RNA-21, HCY, CRP integration may be the risk factors of MACE.Conclusion: 1、The expression of plasma mi RNA-21 in CHD group was up-regulated,There was more significantly up-regulated in expression of plasma mi RNA-21 in AMI group. The expression of plasma mi RNA-1 and mi RNA-133 in AMI group were significantly decreased. 2、The difference expression of mi RNA-1, mi RNA-133 and mi RNA-21 may be related to the severity of coronary stenosis. 3、The specificity and sensitivity of mi RNA-21, mi RNA-1 and mi RNA-133 were high, might be a potential marker for the diagnosis of acute myocardial infarction. 4、The expression of mi RNA-21 in plasma was correlated with CK-MB and c Tn I. The expression of mi RNA-21 in plasma was up-regulated, accompanied by BNP increased, but there was no significant correlation. mi RNA-21 may play a protective role in the myocardial cells after ischemia reperfusion injury and may interfere with the protective mechanism of heart failure.The expression of plasma mi RNA-1 was correlated with CK, CK-MB and CRP.The expression of plasma mi RNA-133 was correlated with CK, CK-MB, c Tn I, WBC and CRP. 5、mi RNA-133 may be a protective factor of coronary heart disease. 6、mi R-21 is a possible risk factor for the occurrence of MACE after stenting. |
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