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微小RNA-499的血浆水平可为冠状动脉搭桥术患者围手术期心肌梗死提供早期指征。

Plasma levels of microRNA-499 provide an early indication of perioperative myocardial infarction in coronary artery bypass graft patients.

作者信息

Yao Youxiu, Du Juan, Cao Xiaoqing, Wang Yang, Huang Yaohua, Hu Shengshou, Zheng Zhe

机构信息

Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Peking, China; Department of Cardiac Surgery, Fuwai Hospital and Cardiovascular Institute, Peking, China; Key Laboratory of Cardiac Regenerative Medicine, Ministry of Health, National Center for Cardiovascular Diseases, Peking, China.

Department of Thoracic Surgery, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing Chest Hospital, Capital Medical University, Tongzhou, Beijing, China.

出版信息

PLoS One. 2014 Aug 11;9(8):e104618. doi: 10.1371/journal.pone.0104618. eCollection 2014.

Abstract

BACKGROUND

Recent studies indicated that microRNAs (miRNAs, miRs) were important for many biological and pathological processes, and they might be potential biomarkers for cardiovascular diseases. The present study aims to determine the release patterns of miRNAs in cardiac surgery and to analyze the ability of miRs to provide early prediction of perioperative myocardial infarction (PMI) in patients undergoing coronary artery bypass graft (CABG) surgery.

METHODOLOGY/PRINCIPAL FINDINGS: Thirty on-pump CABG patients were recruited in this study; and miR-499, miR-133a and miR-133b, cardiac troponin I (cTnI) were selected for measurement. Serial plasma samples were collected at seven perioperative time points (preoperatively, and 1, 3, 6, 12, 24, and 48 hours after declamping) and were tested for cTnI and miRs levels. Importantly, miR levels peaked as early as 1-3 hours, whereas cTnI levels peaked at 6 hours after declamping. Peak plasma concentrations of miRs correlated significantly with cTnI (miR-499, r = 0.583, P = 0.001; miR-133a, r = 0.514, P = 0.006; miR-133b, r = 0.437, P = 0.05), indicating the degree of myocardial damage. In addition, 30 off-pump CABG patients were recruited; miR-499 and miR-133a levels were tested, which were significantly lower in off-pump group than in on-pump group. A prospective cohort of CABG patients (n = 120) was recruited to study the predictive power of miRs for PMI. The diagnosis of PMI strictly adhered to the principles of universal definition of myocardial infarction. The data analysis revealed that miR-499 had higher sensitivity and specificity than cTnI, and indicated that miR-499 could be an independent risk factor for PMI.

CONCLUSION

Our results demonstrate that circulating miR-499 is a novel, early biomarker for identifying perioperative myocardial infarction in cardiac surgery.

摘要

背景

近期研究表明,微小RNA(miRNA,miR)对许多生物学和病理过程都很重要,它们可能是心血管疾病的潜在生物标志物。本研究旨在确定心脏手术中miRNA的释放模式,并分析miR对冠状动脉旁路移植术(CABG)患者围手术期心肌梗死(PMI)进行早期预测的能力。

方法/主要发现:本研究招募了30例体外循环CABG患者;并选择测量miR-499、miR-133a和miR-133b、心肌肌钙蛋白I(cTnI)。在围手术期的七个时间点(术前以及松开主动脉阻断钳后1、3、6、12、24和48小时)采集系列血浆样本,并检测cTnI和miR水平。重要的是,miR水平早在1 - 3小时就达到峰值,而cTnI水平在松开主动脉阻断钳后6小时达到峰值。miR的血浆峰值浓度与cTnI显著相关(miR-499,r = 0.583,P = 0.001;miR-133a,r = 0.514,P = 0.006;miR-133b,r = 0.437,P = 0.05),表明心肌损伤程度。此外,招募了30例非体外循环CABG患者;检测miR-499和miR-133a水平,非体外循环组显著低于体外循环组。招募了一个CABG患者的前瞻性队列(n = 120)来研究miR对PMI的预测能力。PMI的诊断严格遵循心肌梗死通用定义的原则。数据分析显示,miR-499比cTnI具有更高的敏感性和特异性,并表明miR-499可能是PMI的独立危险因素。

结论

我们的结果表明,循环miR-499是一种用于识别心脏手术围手术期心肌梗死的新型早期生物标志物。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb6f/4128681/fc6c7201f358/pone.0104618.g001.jpg

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