| Objective:Today,acute myocardial infarction(AMI)has developed into the most common heart disease,with a high prevalence and mortality.Therefore,timely and accurate clinical diagnosis is undoubtedly vital to many clinical patients and doctors.At present,cardiac troponin(c Tn),which is considered to be the most reliable biomarker,has been widely used in clinical diagnosis.However,previous studies have shown that high levels of c Tn are also detected in other acute and chronic diseases,such as renal failure and skeletal muscle tissue damage.These lead to a relatively low diagnostic accuracy of c Tn,making its detection potentially limited.Thus,it is necessary to explore novel biomarkers with higher specificity and sensitivity for the early diagnosis of AMI.MicroRNA(miRNA)are non-coding single-strandedRNAs consisting of approximately 20 nucleotides.A large number of studies have shown that miRNA can stably exist in the blood.Therefore,the levels of miRNA in peripheral blood can be used as important indicators for disease diagnosis,disease monitoring and prognosis.Studies have shown that miRNA-499 is involved in the differentiation of cardiac stem cells into the structure and function of cardiomyocytes,which is increased in patients with AMI.Studies have shown that miRNA-22 is an important regulator of cardiac remodeling and is widely expressed in the heart.It can be considered as a candidate biochemical marker for the diagnosis of cardiovascular disease.However,many studies on peripheral blood circulating miRNA-499 as a diagnostic standard for AMI are controversial,and the diagnostic value of circulating miRNA-22 in AMI has not been reported in China.Therefore,the main purpose of this study is to explore the diagnostic value of miRNA-499 and miRNA-22 in AMI.Methods:The experimental group included 50 patients with myocardial infarction(AMI)within 12 hours after the onset of chest pain from October 2018 to July 2019.The control group included 50 patients with non-myocardial infarction(N-MI),including 25 patients with unstable angina pectoris(UAP)and 25 healthy controls(HC).The expression levels of miRNA-499 and miRNA-22 were analyzed using quantitative q RT-PCR technology.Results:1 Comparison of serum miRNA-499 and miRNA-22 levelsThe expression level of miRNA-499 gradually increased among the three groups(HC,UAP and AMI),and the miRNA-499 level of AMI was significantly higher than that of UAP and HC.MiRNA-499 showed significant differences between HC and AMI,and between UAP and AMI(P<0.05).However,there was no difference in the expression level of miRNA-499 between HC and UAP(P>0.05).Contrary to the expression trend of miRNA-499,the level of miRNA-22 was gradually reduced among the three groups.The level of miRNA-22 in AMI group was significantly lower than that in UAP and HC group.The relative levels of MiRNA-22 were found to be statistically different in comparisons between the AMI group and the HC group,and between the AMI group and the UAP group(P<0.05).2 Analysis of the sensitivity and specificity of miRNA-499 and miRNA-22The area under the ROC curve of miRNA-499 and miRNA-22 was 0.958 and 0.908,respectively.When the levels of miRNA-499 and miRNA-22 were 0.377 and 0.946 respectively,the sensitivity of diagnosing AMI was 86.00% and 86.00%,and the specificity was 98.00% and 94.00%,respectively.3 Logistic regressionLogistic regression was used to analyze the independent predictive ability of miRNA-499 and miRNA-22 on AMI.The results showed that miRNA-499 and miRNA-22 were independent predictors of AMI.4 Correlation analysisSpearman rank correlation analysis was used to analyze the relationship between miRNA and various indicators in AMI and UAP patients.The results showed that miRNA-499 was positively correlated with white blood cell count,and its correlation coefficient r was 0.51(P<0.001).MiRNA-22 was negatively correlated with white blood cell count,and its correlation coefficient r was-0.50(P<0.001).There was a negative correlation between miRNA-499 and miRNA-22,and the correlation coefficient r was-0.52(P<0.001).Conclusion:MiRNA-499 and miRNA-22 have the capability to be potential biomarkers for the diagnosis of AMI.And with the continuous improvement of miRNA detection technology,more accurate,fast and cheap detection methods may appear.At the same time,considering the limitations of sample testing time and the number of samples collected,further research is needed to confirm the results. |
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