Department of Molecular Pathology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran.
Faculty of Science, Department of Biology, Persian Gulf University, Bushehr, Iran.
Arch Med Res. 2021 Jan;52(1):69-75. doi: 10.1016/j.arcmed.2020.10.004. Epub 2020 Nov 28.
Early-onset coronary artery disease (EOCAD) increases the risk of major cardiac adverse events (MACE) at the level of safety/effectiveness-related events. Since adverse events affect the quality of life of young patients with EOCAD, MACE prediction is of great importance for improving medical decision-making.
We sought to determine whether the most important inflammation-related microRNAs in atherogenesis could predict MACE among patients with EOCAD.
This nested case-control study recruited 143 young patients (males ≤45 and females ≤55 years old), selected from a cohort of patients with premature coronary atherosclerosis at a median follow-up period of 64.1 months. Total RNAs were extracted from their peripheral blood mononuclear cells. The expression levels of 18 miRNAs, which are involved in inflammation and atherogenesis, were analyzed via quantitative reverse transcription PCR.
A scoring model based on the upregulation of miR-146a_1 and miR-342_1, along with a history of myocardial infarction and the chronic usage of antithrombotic drugs, was able to predict MI/death at the level of safety-related events (higher vs lower risk scores: sHR: 4.61, 95% CI: 1.57-13.57, and p = 0.005). Another prediction model based on the downregulation of miR-145_1, age, and a history of unstable angina was also able to predict revascularization at the level of effectiveness-related events (higher vs lower risk scores: sHR: 2.90, 95% CI: 1.49-5.66, and p = 0.002).
Our results highlighted the role of miRNAs in adverse cardiac events and suggest that miR-146a_1, miR-342_1, and miR-145_1 may be useful biomarkers in predictive and preventive cardiology.
早发冠状动脉疾病（EOCAD）会增加安全性/有效性相关事件的主要心脏不良事件（MACE）风险。由于不良事件会影响年轻 EOCAD 患者的生活质量，因此 MACE 预测对于改善医疗决策非常重要。
我们旨在确定动脉粥样硬化形成过程中最重要的炎症相关 microRNAs 是否可以预测 EOCAD 患者的 MACE。
本巢式病例对照研究纳入了 143 名年轻患者（男性≤45 岁，女性≤55 岁），他们从患有早发性冠状动脉粥样硬化的患者队列中选择，中位随访时间为 64.1 个月。从他们的外周血单核细胞中提取总 RNA。通过定量逆转录 PCR 分析 18 种参与炎症和动脉粥样硬化形成的 microRNAs 的表达水平。
基于 miR-146a_1 和 miR-342_1 的上调，以及心肌梗死病史和抗血栓药物的慢性使用，建立了一个评分模型，该模型能够预测安全性相关事件中的 MI/死亡（较高风险评分与较低风险评分相比：sHR：4.61，95%CI：1.57-13.57，p=0.005）。另一个基于 miR-145_1 下调、年龄和不稳定型心绞痛病史的预测模型也能够预测有效性相关事件中的血运重建（较高风险评分与较低风险评分相比：sHR：2.90，95%CI：1.49-5.66，p=0.002）。
我们的研究结果强调了 microRNAs 在不良心脏事件中的作用，并表明 miR-146a_1、miR-342_1 和 miR-145_1 可能是预测和预防心脏病学中有用的生物标志物。
