Cortez-Dias Nuno, Costa Marina C, Carrilho-Ferreira Pedro, Silva Doroteia, Jorge Cláudia, Calisto Carina, Pessoa Teresa, Robalo Martins Susana, de Sousa João Carvalho, da Silva Pedro Canas, Fiúza Manuela, Diogo António Nunes, Pinto Fausto J, Enguita Francisco J
University Hospital Santa Maria, Department of Cardiology, Lisbon Academic Medical Centre, CCUL, Lisbon University.
Circ J. 2016 Sep 23;80(10):2183-91. doi: 10.1253/circj.CJ-16-0568. Epub 2016 Sep 2.
MicroRNAs (miRNAs) are key players in cardiovascular development and disease. However, not only miRNAs of a cardiac origin have a critical role in heart function. Recent studies have demonstrated that miR-122-5p, a hepatic miRNA, increases in the bloodstream during ischemic cardiogenic shock and it is upregulated in the infarcted myocardium. The aim of the present study was to determine the potential of circulating miR-122-5p as a biomarker for early prognostic stratification of ST-segment elevation acute myocardial infarction (STEMI) patients.
One hundred and forty-two consecutive STEMI patients treated with primary angioplasty were included in the study. Serum levels of miR-1-3p, -122-5p, -133a-3p, -133b, -208b-3p and -499a-5p were measured at the time of cardiac catheterization by quantitative polymerase chain reaction and related to in-hospital and long-term outcome. During a follow up of 20.8 months, 9 patients died, 6 had recurrence of myocardial infarction, and 26 patients suffered an adverse cardiovascular event. Event-free survival was significantly worse in patients with a higher miR-122-5p/133b ratio (3rd tertile distribution, above 1.42 Log(10)), having almost a 9-fold higher risk of death or myocardial infarction and a 4-fold higher risk of adverse cardiovascular events.
This study showed that the miR-122-5p/133b ratio is a new prognostic biomarker for the early identification of STEMI patients at a higher risk of developing major adverse events after undergoing primary percutaneous coronary intervention. (Circ J 2016; 80: 2183-2191).
微小RNA(miRNA)是心血管发育和疾病的关键参与者。然而,并非只有源自心脏的miRNA对心脏功能起关键作用。最近的研究表明,肝脏miRNA miR-122-5p在缺血性心源性休克期间会在血液中增加,并且在梗死心肌中上调。本研究的目的是确定循环miR-122-5p作为ST段抬高型急性心肌梗死(STEMI)患者早期预后分层生物标志物的潜力。
本研究纳入了142例接受直接经皮冠状动脉介入治疗的连续STEMI患者。在心脏导管插入术时,通过定量聚合酶链反应测量血清中miR-1-3p、-122-5p、-133a-3p、-133b、-208b-3p和-499a-5p的水平,并将其与住院期间和长期预后相关联。在20.8个月的随访期间,9例患者死亡,6例发生心肌梗死复发,26例患者发生不良心血管事件。miR-122-5p/133b比值较高(三分位数分布的第3三分位数,高于1.42 Log(10))的患者无事件生存期明显较差,死亡或心肌梗死风险几乎高出9倍,不良心血管事件风险高出4倍。
本研究表明,miR-122-5p/133b比值是一种新的预后生物标志物,可用于早期识别接受直接经皮冠状动脉介入治疗后发生主要不良事件风险较高的STEMI患者。(《循环杂志》2016年;80:2183 - 2191)