Su Qiang, Ye Ziliang, Sun Yuhan, Yang Huafeng, Li Lang
a Department of Cardiology , The First Affiliated Hospital of Guangxi Medical University , 6 Shuangyong Road, Nanning, 530021 , China.
Scand J Clin Lab Invest. 2018 Jul;78(4):318-324. doi: 10.1080/00365513.2018.1467571. Epub 2018 Apr 27.
To investigate the relationship between miRNA-30e level in circulation and no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) during primary percutaneous coronary intervention (pPCI). A total of 255 consecutive patients with STEMI undergoing pPCI were enrolled in this study. These patients were divided into two groups according to the occurrence of reflow during pPCI, namely normal-reflow group with 214 cases and no-reflow group with 41 cases. The plasma levels of miRNA-30e were quantified using real-time quantitative polymerase chain reaction. The plasma levels of miRNA-30e were significantly lower in the no-reflow group as compared to the normal-reflow group (p < .05). Also, miRNA-30e was positively correlated with left ventricular ejection fraction (LVEF) and negatively correlated with hs-CRP levels (p < .05). Multivariate logistic regression analyses indicated that the plasma level of miRNA-30e (OR = 0.732, 95% CI 0.674-0.851, p = .034), hs-CRP (OR = 1.353, 95% CI 1.129-1.635, p = .012) and Killip class ≥2 at admission (OR = 1.263, 95% CI 1.023-1.532, p = .027), were independent risk factors for no-reflow during pPCI. When plasma miRNA-30e level was used as the test variable, the area under the curve was 0.914 (p < .05) by ROC curve analysis. Lower miRNA-30e levels at admission are associated with no-reflow in STEMI patients undergoing pPCI and may play an important role in the pathogenesis of no-reflow. Plasma miRNA-30e level was an independent predictor of no-reflow during pPCI in patients with STEMI. Therefore, early detection of plasma miRNA-30e level can be a preliminary assessment for risk of no-reflow during pPCI.
探讨急性ST段抬高型心肌梗死(STEMI)患者在直接经皮冠状动脉介入治疗(pPCI)期间循环中miRNA - 30e水平与无复流现象之间的关系。本研究共纳入255例连续接受pPCI的STEMI患者。这些患者根据pPCI期间复流情况分为两组,即214例的正常复流组和41例的无复流组。采用实时定量聚合酶链反应对血浆miRNA - 30e水平进行定量。与正常复流组相比,无复流组血浆miRNA - 30e水平显著降低(p < 0.05)。此外,miRNA - 30e与左心室射血分数(LVEF)呈正相关,与hs - CRP水平呈负相关(p < 0.05)。多因素logistic回归分析表明,血浆miRNA - 30e水平(OR = 0.732,95%CI 0.674 - 0.851,p = 0.034)、hs - CRP(OR = 1.353,95%CI 1.129 - 1.635,p = 0.012)及入院时Killip分级≥2(OR = 1.263,95%CI 1.023 - 1.532,p = 0.027)是pPCI期间无复流的独立危险因素。当以血浆miRNA - 30e水平作为检验变量时,ROC曲线分析显示曲线下面积为0.914(p < 0.05)。入院时较低的miRNA - 30e水平与接受pPCI的STEMI患者无复流相关,且可能在无复流的发病机制中起重要作用。血浆miRNA - 30e水平是STEMI患者pPCI期间无复流的独立预测因子。因此,早期检测血浆miRNA - 30e水平可作为pPCI期间无复流风险的初步评估指标。