Expression And Clinical Significance Of Serum Mir-24 In Patients With Stable Angina Pectoris

Objective(s):Coronary atherosclerotic heart disease is a common and frequently occurring disease in China,which seriously endangers people’s health and life.CHD is caused by the formation of arterial plaque and chronic local inflammation of arterial endothelial cells resulting in lumen stenosis.Cardiac ischemia and hypoxia lead to apoptosis of cardiomyocytes,hypertrophy of remaining cardiomyocytes,over secretion of inflammatory factors by endothelial cells and proliferation and activation of cardiac fibroblasts,thus causing cardiac remodeling.Coronary angiography is the"gold standard" for the diagnosis of CHD,which has some shortcomings such as invasive,expensive,high risk and difficult promotion.Only when the stenosis of the angiographic results was found.In 70%of cases,stent implantation was needed to improve blood supply,but some patients had obvious clinical symptoms.After the completion of coronary angiography,the coronary artery was slightly stenosis,or even normal,without the need of stent implantation.In this case,coronary angiography only played a diagnostic role.There is an urgent need for a novel biomarker that can initially assess the severity of coronary stenosis in patients.The detection index selected in this study was mir-24,which is closely related to endothelial cell inflammation.By analyzing the correlation between the gensini score and the relative expression level of mir-24 in each group for coronary artery stenosis,the potential possibility of mir-24 in preliminary predicting the degree of coronary artery stenosis in patients was explored.The aim is to provide a non-invasive diagnostic index for clinical identification and monitoring of high-risk patients with coronary heart disease.Methods:Choosing 60 patients hospitalized in the Department of Cardiology,South Hospital of Galmett Hospital,Kunming Medical University from October 2019 to October 2020 were diagnosed with stable angina pectoris for the first time.Basic information(gender,age,smoking history,alcohol consumption history,history of hypertension,history of diabetes mellitus,heart rate on admission,systolic blood pressure on admission)and laboratory results(TC,TG,HDL-C,LDL-C,UA,CTnT,NEU,LYM,SCR)of all subjects were collected.Informed consent was signed and serum samples were collected.All patients underwent coronary angiography.According to the results of coronary angiography,they were divided into 1 vessel stenosis group,2 vessel stenosis group,and 3 vessel stenosis group.Left main disease was included in 2 vessel stenosis group.The patients were calculated by gensini scoring system by the results of coronary angiography.The patients were divided into group A(≤19 points,n=15 cases),group B(20-59 points,n=15 cases),group C(60-99 points,n=15 cases),and group D(≥100 points,n=15 cases).Real time fluorescent quantitative PCR(RT-qPCR)was used for detect the relative expression level of mir-24 by using 2-ΔΔCT method.Using U6 as internal reference.SPSS 16.0 software was used for statistical analysis of data.The measurement data subject to or approximately subject to normal distribution were represented by mean ± standard deviation(X±S),and the measurement data with skewed distribution were represented by median and quartile spacing M(P25,P75).Gender,smoking history,drinking history,history of hypertension and history of diabetes mellitus were directly counted,and the chi-square test was used to analyze the differences between the groups.The indexes of age,TC,HDL-C,LDL-C,UA,NEU,LYM,SCR,and mir-24 of the subjects were expressed by one-way ANOVA,and the mean ± standard deviation(X±S)was used.Rank sum test was used to compare the concentrations of TG and CTnT,and M(P25,P75)was used to represent the quartile spacing.The correlation between gensini score and the expression level of mir-24,between gensini score and various indicators,and between the expression level of mir-24 and various indicators of the subjects was analyzed by Pearson and Spearman.mir-24 was associated with severe coronary stenosis(>70%)were analyzed by Logistic regression.α=0.05 is the test level.p<0.05,the difference was statistically significant.ROC curves were used to analyze the efficacy of mir-24 in the diagnosis of severe coronary stenosis(>70%).Results:1、There were significant differences in gender,history of diabetes mellitus,history of hypertension,TG,HDL-C and mir-24 levels among groups A,B,C and D(x 2=6.67,p=0.01),(x 2=1.67,p=0.005),(x 2=8.07,p=0.003),(Z=-6.27,p=0.023),(F=4.22,p=0.009),(F=10.87,p=0.000).p<0.05,the difference was statistically significant.The differences in age,smoking,alcohol consumption,systolic blood pressure,heart rate,TC,LDL-C,UA,CTnT,NEU,LYM and SCR were without statistical significance,p>0.05,.2、The pair-wise relation analysis of mir-24,gensini,TC,TG,HDL-C and other indicators showed that the gensini score of the subjects in each group was only negatively correlated with mir-24(r=-0.519,p=0.00).p<0.05,the difference was statistically significant.3、Correlation analysis between mir-24 and the number of lesions:the expression level of mir-24 was lower in patients with more lesions,and the difference between the groups with 3-vessel lesions and 1-vessel lesions(p=0.00,p<0.05),3-vessel disease and 2-vessel disease(p=0.00,p<0.05)was statistically significant.4.Binary logistic regression analysis of risk factors for severe coronary stenosis showed that:Smoking,history of diabetes mellitus,history of hypertension and mir-24 were risk factors for severe coronary stenosis,(OR=0.402,p=0.01),(OR=0.284,p=0.028),(OR=0.3,p=0.02)and(OR=0.308,p=0.003).p<0.05,the difference was statistically significant.5、The cut-off value of mir-24 in the diagnosis of severe coronary stenosis(>70%)was 2.799,with AUC of 0.906,specificity of 90%,sensitivity of 90%,95%CI(0.818-0.986).Conclusion(s):(1)The expression level of mir-24 in patients with coronary atherosclerotic heart disease was significantly negatively correlated with the degree of coronary artery stenosis,which could be used to preliminarily judge and evaluate the degree of coronary artery stenosis.(2)The level of mir-24 is a risk factor for severe coronary artery stenosis(>70%),may be used as a novel biomarker for severe coronary artery stenosis with good sensitivity and specificity.