Evaluation Of Circulating MicroRNA-1 And MicroRNA-133a In Early Diagnosis Of Acute Myocardial Infarction

Research backgroundAcute myocardial infarction(AMI)is a high morbidity and mortality of the disease is a kind of persistent and severe acute myocardial ischemia and necrosis.According to a survey of 2008,about three to four million people suffering from acute myocardial infarction every year.Early reperfusion significantly effective in the treatment of acute myocardial infarction and decrease the mortality rate with the development of molecular biology and technology,nucleotide based biomarker,has aroused considerable interest.Circulating microRNAs in patients with acute myocardial infarction(AMI)diagnostic value is an important hot topic in clinical research and need to be resolved.The first of the biological molecular diagnosis of AMI marker is myoglobin.Creatine kinase(CK)and its isoenzyme(CK-MB),lactate dehydrogenase isoenzyme 1(LDH-1)in myocardial infarction injury.Although they did not show specific,but for many years we have been using these markers to the diagnosis of AMI patients with chest pain.In early 90,changed this situation: first,quality monitoring to replace the CK-MB isoenzyme of creatine kinase activity,followed by cardiac specific protein,troponin T and I(cTnT,cTnI)to replace the marker.At present,a new generation of ultra sensitive troponin(HS-cTnT and HS-cTnI)detection concentration is far below the old traditional circulating troponin testing,monitoring sensitivity of about 10 times,showed good diagnostic performance.Therefore,clinical guidelines for acute myocardial infarction hs-cTnT or hs-cTnI evaluation the diagnosis of AMI.Found near the bed,such as the existence of hypertensive crisis and heart failure,renal pathological conditions of patients HS-cTn,in the detection of the expression level increased significantly,possible falsepositive,especially in elderly patients with chronic diseases of the merger,the differential diagnosis is a realistic problem of.Hs-cTn detection Another drawback of the method is in the onset of myocardial infarction after the first few hours,their lack of sensitivity,because of their expression level in 3 to 6 hours after the onset of peak.Therefore,in order to further reduce the mortality of AMI,we urgently need a higher sensitivity and specificity of biomarkers,especially difficult to diagnose not typical of aged patients with chest pain.Recent studies have shown that myocardial injury after specific micRNAs was released to.MicRNAs in the coronary circulation could be the release of cell necrosis,cell membrane rupture,passive into the blood circulation,but also may be due to active release in response to ischemia induced by myocardial cells.It can be speculated that circulating micRNAs may be early markers of myocardial necrosis.Lippi et al on circulating different micRNA in the diagnosis of AMI in the sensitivity and specificity of quantitative description,such as micRNA-499-5p,-133,-1,-663 b.,however,the increased expression of these miRNA in coronary artery occlusion is the most favorable evidence for early detection of myocardial injury and the prognostic value ofIn short,through the blood circulation center of muscle derived micRNAs as a diagnostic biomarker for AMI of pioneering results,encourage technological progress,and encourage larger clinical studies to elucidate the value of diagnosis between micRNAs and HS-CTN.As you can imagine,at this stage,biomarkers can improve the accuracy of a new the rate of diagnosis of AMI,especially in the early diagnosis of myocardial infarction in elderly patients.Objective:QRT-PCR was used to detect the expression level of AMI in plasma of patients with AMI,and to evaluate the value of microRNAs in the early diagnosis of the disease.Methods:A total of 17 patients with acute myocardial infarction were enrolled in this study,and 25 healthy volunteers in the control group.The patients received venous blood from the onset of 4h,8h,12 h,24h,48 h,72h,1W(week)and monitored the large amounts of MicroRNAs in the blood.SPSS17.0 software package was used for statistical data processing.The independent sample T test was used between the two groups,and the.P<0.05 expression was statistically significant.Results:1.The expression of MicroRNA-1 was significantly in plasma in patients with myocardial infarction,significantly higher than the control group,the difference was statistically significant,P<0.05.in chest pain patients with myocardial infarction attack4 h,detected the expression level began to rise,8 hours to reach the peak,and at the other time points(4h,12 h,24h,48 h,72h,1W),also significantly higher than the normal level.2.The expression of MicroRNA-133 a was significantly in plasma in patients with myocardial infarction,the expression level is lower than the healthy control group,the difference was statistically significant,P<0.05.in heart attacks is to detect the expression of 4H in chest pain decreased,and 24 h 1W,a lower peak,the other time points(4h,12 h,48h,1W)was lower than the normal level;3.The level of expression of MicroRNA-1 8h in plasma of patients with AMI compared with other time points,the expression was significantly increased;and the expression level of MicroRNA-133 a in 24 h and 1W compared with other time points,the expression was down regulated;4.In these patients,miR-133 a and cTnI showed the same time trend.Importantly,there was no significant interaction between the time course of miRNAs and cTnI.Conclusion:MicroRNA-1 and MicroRNA-133 a can be used as a clinical diagnosis of acute myocardial infarction with new potential biochemical markers in patients with myocardial infarction.Both peripheral circulation in plasma,compared to healthy control group the expression level,there are significant differences.In view of changes in the value of microRNA-1 and microRNA-133 a in the diagnosis of myocardial infarction,further clarify their expression and expression the mechanism of down-regulation after myocardial infarction,targeted therapy,provides a possible way.