| Objective:To investigate the expression levels of serum exosomal miR-210-3p and vascular endothelial growth factor(VEGF)in patients with acute myocardial infarction(AMI)and their relationship with the prognosis of AMI patients.Methods:40 patients with AMI admitted to the Department of Cardiology of Taizhou People’s Hospital from January 2022 to June 2022 were selected.All patients underwent coronary angiography and primary percutaneous coronary intervention(PCI).20 healthy subjects in the hospital during the same period were selected.All enrolled subjects were extracted 10 m L of peripheral venous blood in the morning on the next day after admission.Exosomes and RNA were extracted by kit method.The expression of exosomal miR-210-3p was detected by quantitative real-time polymerase chain reaction(qRT-PCR).The concentration of exosomal VEGF was detected by enzyme linked immunosorbent assay(ELISA).The expression levels of exosomal miR-210-3p and VEGF in AMI group and control group were compared.The major adverse cardiovascular events(MACE)of AMI patients within 6 months after discharge were followed up by consulting the electronic medical record system and telephone follow-up.The expression levels of serum exosomal miR-210-3p and VEGF between the MACE group and the nonMACE group were compared to determine the diagnostic value of serum exosomal miR-210-3p and VEGF for MACE after AMI.Through the difference analysis between the two groups,the indicators with differences between the two groups were screened out,and binary logistic regression analysis was performed to determine whether they were the influencing factors of MACE in AMI patients within half a year of discharge.For patients who came to the hospital for reexamination of echocardiography within half a year,they were divided into LVEF improvement group and LVEF reduction group according to the changes of LVEF,and serum exosomal miR-210-3p and VEGF were compared between the two groups.SPSS26.0 statistical software was used to analyze the clinical data of the enrolled patients and the indicators detected in this study.Graph Pad Prism8 software was used for drawing.Results:1.The relative expression of serum exosomal miR-210-3p in AMI group was significantly higher than that in control group(6.39±1.00 VS 1.03±0.26,P<0.001).The concentration of exosomal VEGF in AMI group was significantly higher than that in control group[611.58(498.78,695.13)pg/m L VS 170.84(128.02,200.61)pg/m L,P<0.001].2.The expression level of exosomal miR-210-3p in MACE group was lower than that in non-MACE group(5.54±0.73 VS 6.68±0.91,P=0.001),and the concentration of exosomal VEGF in MACE group was lower than that in non-MACE group[484.16(414.19,641.34)pg/m L VS 626.20(521.76,720.72)pg/m L,P=0.015].ROC curve was drawn with the presence or absence of MACE as the state variable,and miR-210-3p and VEGF as the test variables.The area under the curve of miR-210-3p was 0.830,the best cut-off value was 6.425,the sensitivity was 56.7%,and the specificity was 1.The area under the curve of VEGF was 0.758,the best cutoff value was 496.7pg/m L,the sensitivity was 93.3%,and the specificity was 60 %.There were differences in age,NTpro BNP,relative expression level of exosomal miR-210-3p,and exosomal VEGF concentration between the MACE group and the non-MACE group.They were included in the multivariate logistic regression analysis model.The expression level of exosomal miR-210-3p was an independent predictor of MACE in AMI patients within half a year after surgery(P<0.05).3.The relative expression of exosomal miR-210-3p in the LVEF improvement group was significantly higher than that in the LVEF reduction group(7.26±0.73 VS 5.65±0.78,P<0.001).The concentration of exosomal VEGF was higher than that in the LVEF decreased group(737.17±243.11pg/m L VS 537.71±123.57,P=0.039).Conclusion:1.The expression of miR-210-3p and the concentration of VEGF in serum exosomes of patients with acute myocardial infarction were higher than those in the control group.2.The expression of miR-210-3p and VEGF in serum exosomes of patients with MACE within half a year after discharge were lower than those of patients without MACE.The expression level of miR-210-3p in serum exosomes can be used as an independent predictor of prognosis in patients with acute myocardial infarction.3.The expression of miR-210-3p and the concentration of VEGF in serum exosomes of patients with acute myocardial infarction with improved LVEF were higher than those with decreased LVEF.MiR-210-3p and VEGF may be related to the improvement of cardiac function during the recovery period of acute myocardial infarction. |
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