Department of Medicine and Surgery, University of Parma, Parma, Italy.
Division of Cardiology, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy.
Sci Rep. 2019 Dec 20;9(1):19574. doi: 10.1038/s41598-019-56047-0.
Acute myocardial infarction is primarily due to coronary atherosclerotic plaque rupture and subsequent thrombus formation. Platelets play a key role in the genesis and progression of both atherosclerosis and thrombosis. Since platelets are anuclear cells that inherit their mRNA from megakaryocyte precursors and maintain it unchanged during their life span, gene expression profiling at the time of an acute myocardial infarction provides information concerning the platelet gene expression preceding the coronary event. In ST-segment elevation myocardial infarction (STEMI), a gene-by-gene analysis of the platelet gene expression identified five differentially expressed genes: FKBP5, S100P, SAMSN1, CLEC4E and S100A12. The logistic regression model used to combine the gene expression in a STEMI vs healthy donors score showed an AUC of 0.95. The same five differentially expressed genes were externally validated using platelet gene expression data from patients with coronary atherosclerosis but without thrombosis. Platelet gene expression profile highlights five genes able to identify STEMI patients and to discriminate them in the background of atherosclerosis. Consequently, early signals of an imminent acute myocardial infarction are likely to be found by platelet gene expression profiling before the infarction occurs.
急性心肌梗死主要是由于冠状动脉粥样硬化斑块破裂，随后血栓形成。血小板在动脉粥样硬化和血栓形成的发生和进展中起着关键作用。由于血小板是无核细胞，它们从巨核细胞前体继承其 mRNA，并在其寿命内保持不变，因此在急性心肌梗死时进行基因表达谱分析可以提供有关冠状动脉事件发生前血小板基因表达的信息。在 ST 段抬高型心肌梗死（STEMI）中，对血小板基因表达的基因逐个分析确定了五个差异表达的基因：FKBP5、S100P、SAMSN1、CLEC4E 和 S100A12。用于将 STEMI 与健康供体评分相结合的基因表达的逻辑回归模型显示 AUC 为 0.95。使用来自无血栓形成的冠状动脉粥样硬化患者的血小板基因表达数据对相同的五个差异表达基因进行了外部验证。血小板基因表达谱突出了五个能够识别 STEMI 患者并在动脉粥样硬化背景下区分他们的基因。因此，通过在梗死发生之前进行血小板基因表达谱分析，可能会在急性心肌梗死发生之前找到即将发生急性心肌梗死的早期信号。
