Changes Of MiR-147b And ADAM15 In Peripheral Plasma Of Patients With Acute Myocardial Infarction

Background:Acute myocardial infarction(AMI)is one of the most common cardiovascular diseases.Epidemiology shows that its morbidity and mortality are still on the rise.The most commonly used diagnostic markers for myocardial infarction in the clinic are Creatine kinase isoenzyme(CK-MB)and troponin,but they are still susceptible to be influenced by heart failure,malignant tumors,renal insufficiency,infection and other diseases,which affects diagnostic accuracy.Therefore,it is extremely important to explore the pathogenesis of AMI and to find the ideal mark for screening the disease.A disintegrin and metallo-proteinase 15(ADAM15)is a transmembrane protein,and luciferase reporter gene experiments confirmed that ADAM15 is regulated by miR-147 b as its target gene.A microarray study found that miR-147 b is elevated in patients with myocardial infarction.Other studies have shown abnormal expression of ADAM15 in animal models of myocardial infarction.However,the role of miR-147 b and ADAM15 in AMI patients,and their relationship is still unclear.Objective:In this study,the expression levels of miR-147 b and ADAM15 in peripheral blood of AMI group and control group were detected,and the difference in expression levels between them was compared,and analyzed whether they can be used as diagnostic biomarkers for AMI and explored their potential mechanisms of AMI.Method:According to the spirit of the Helsingin Declaration,86 patients from our hospital were enrolled this study during September 2018 to December 2018.Among them,63 patients in the AMI group,the AMI diagnostic criteria refer to the 2012 third edition of the global myocardial infarction diagnosis guide published by the European Journal of Cardiology.Twenty-three patients in the control group underwent angiography without coronary stenosis.The peripheral venous blood was collected and centrifuged,and the plasma was placed in a refrigerator at-20? for storage.The expression levels of miR-147 b in periphaeral plasma of patients was detected by real-time polymerase chain reaction(qRT-PCR)and the expression of ADAM15 in periphaeral plasma of patients was detected by enzyme-linked immunosorbent assay.The Spearman correlation test was used to assess the relationship between the expression levels of miR-147 b and ADAM15 in plasma.A receiver operating characteristic curve(ROC)was used to assess the predictive power of circulating miR-147 b and ADAM15 in patients with AMI.The area under the ROC curve(AUC)is used to estimate the predictive power and the best cut off point for the selected variable.Results:1.There were not significant difference between control group and AMI group in age?gender?blood pressure?heart rate?smoking history?drinking history?history of diabetes?history of hypertension?TG?TC?LDL-C?apolipoprotein-B?lipoprotein(a)?creatinine?uric acid,(p>0.05).2.Compared with the control group,the expression level of miR-147 b in the AMI group was significantly increased by 7.03(2.22,58.24)to 1.11(0.56,2.03),p<0.01;the expression level of ADAM15 in the AMI group was significantly down-regulated by 7.50(6.64,9.25)pg / ml to 10.01(7.65,13.40)pg / ml,p <0.01.3.There were not significant difference in the expression levels of miR-147 b and ADAM15 among the single myocardial infarction group,acute myocardial infarction with hypertension and diabetes group,acute myocardial infarction with hypertension group and acute myocardial infarction with diabetes group,(p< 0.05).4.There was not correlation between miR-147 b and ADAM15 expression levels in plasma of patients with AMI,(r=-0.019,p>0.05).5.The ROC analysis showed that the AUC of miR-147 b was 0.812(95% CI: 0.723-0.900;p<0.01),the optimal cut-off value was 3.2189,and the sensitivity and specificity were 71.4% and 91.3%;and the AUC of 1/AMAM15 was 0.685(95% CI: 0.554-0.815;p< 0.01),the optimal cut-off value was 0.1154,and the sensitivity and specificity were 69.8% and 65.2%.6.There was a positive correlation between cTnI level and miR-147 b level in plasam of patients with AMI(r=0.262,p<0.05).There was not correlation between cTnI level and ADAM15 level in plasam of patients with AMI(r=-0.067,p>0.05).7.There was a positive correlation between CK-MB level and miR-147 b level in plasam of patients with AMI(r=0.310,p<0.05),and there was not correlation between CK-MB level and miR-147 b level in plasam of patients with AMI(r=-0.056,p>0.05).Conclusions:1.The expression level of miR-147 b or ADAM15 in plasma both displayed predictive potency for AMI,might be as additional biomarker for AMI.MiR-147 b has higher diagnostic value for acute myocardial infarction than ADAM15.2.The level of miR-147 b in plasma of patients with acute myocardial infarction was positively correlated with the levels of CK-MB and c-TnI.