Zhang Lizhu, Chen Xi, Su Tong, Li Heng, Huang Qiang, Wu Dan, Yang Chengjian, Han Zhijun
1 Department of Cardiology, 2 Department of Laboratory Medicine, Wuxi Second People's Hospital of Nanjing Medical University, Wuxi 214002, China.
J Thorac Dis. 2015 Mar;7(3):303-8. doi: 10.3978/j.issn.2072-1439.2015.02.05.
miRNAs are known to play a crucial role in cardiac development, and the expression of miRNA is altered in the diseased heart. The aim of this study was to investigate the value of plasma microRNA-499 (miR-499) as a novel biomarker for early diagnosis of acute myocardial infarction (AMI).
Enrolled in this study were 227 patients with chest pain on presentation to the departments of emergency and cardiology of Wuxi Second People's Hospital between October 2011 and May 2014. Additional 100 healthy individuals who received physical examination in the same hospital during the same period were used as control. Plasma was collected at admission, and the abundance of miR-499 was measured using reverse transcriptase-polymerase chain reaction (RT-PCR).
MiR-499 was significantly elevated in 142 patients diagnosed with AMI as compared with 85 patients in non-AMI group and 100 subjects in healthy control group. Plasma miR-499 were already detectable in the plasma as early as 1 h after onset of chest pain in AMI patients, and continued to increase gradually without any sign of decreasing tendency within 9 h in AMI patients. miR-499 was highly positively correlated with the serum creatine kinase-MB (CK-MB) and cTnI. The area under the curve (AUC) of miR-499 for the diagnosis of AMI was 0.86, with an optimal cut-off value of 4.79, sensitivity of 80%, and specificity of 80.28%.
miR-499 was shown to substantially increase the diagnostic accuracy of CK-MB and cTnI in the diagnosis of AMI, and therefore it may prove to be a useful marker for early diagnosis of AMI.
已知微小RNA（miRNA）在心脏发育中起关键作用，且在患病心脏中miRNA的表达会发生改变。本研究旨在探讨血浆微小RNA-499（miR-499）作为急性心肌梗死（AMI）早期诊断新生物标志物的价值。
选取2011年10月至2014年5月期间在无锡市第二人民医院急诊科和心内科就诊的227例胸痛患者。同期在同一医院接受体检的另外100名健康个体作为对照。入院时采集血浆，采用逆转录-聚合酶链反应（RT-PCR）检测miR-499的丰度。
与非AMI组的85例患者和健康对照组的100名受试者相比，142例诊断为AMI的患者中miR-499显著升高。AMI患者胸痛发作后1小时血浆中即可检测到miR-499，且在9小时内持续逐渐升高，无下降趋势。miR-499与血清肌酸激酶同工酶（CK-MB）和肌钙蛋白I（cTnI）高度正相关。miR-499诊断AMI的曲线下面积（AUC）为0.86，最佳截断值为4.79，灵敏度为80%，特异性为80.28%。
miR-499在AMI诊断中显著提高了CK-MB和cTnI的诊断准确性，因此可能是AMI早期诊断的有用标志物。
