Department of Cardiothoracic Surgery, Affiliated Changzhi People's Hospital of Shanxi Medical University, Changzhi, China.
Department of Cardiothoracic Surgery, Second Hospital of Shanxi Medical University, School of Medicine, Shanxi Medical University, Taiyuan, China,
Cardiology. 2021;146(3):400-408. doi: 10.1159/000509275. Epub 2021 Mar 17.
This study aimed to explore the association of 14 proangiogenic microRNAs (miRNAs) with major adverse cardiac and cerebrovascular events (MACCE) occurrence in unprotected left main coronary artery disease (ULMCAD) patients who underwent coronary artery bypass grafting (CABG).
A total of 196 ULMCAD patients who underwent first ever CABG were recruited. The peripheral blood samples were collected prior to CABG, and then plasma samples were separated to detect expressions of 14 proangiogenic miRNAs by the reverse transcription quantitative PCR. Patients were regularly followed up to MACCE occurrence or 36 months after CABG.
MACCE occurrence at 1 year, 2 years, and 3 years was 7.1, 11.2, and 14.3%, respectively, and accumulating MACCE occurrence time was 32.7 (95% confidence interval: 31.5-33.9) months. Both Kaplan-Meier curves and univariate Cox's regression analyses displayed that miR-let-7f, miR-19a, miR-126, miR-130a, and miR-378 high expressions were associated with lower accumulating MACCE occurrence. Furthermore, forward stepwise multivariate Cox's regression disclosed that miR-let-7f high expression and miR-378 high expression independently predicted decreased accumulating MACCE occurrence, whereas BMI (>25.0 kg/m2), diabetes, previous stroke, and higher disease extent were independent predictive factors for elevated accumulating MACCE occurrence.
Measurement of circulating proangiogenic miRNAs especially miR-let-7f, miR-19a, miR-126, miR-130a, and miR-378 helps predict MACCE risk in ULMCAD patients who underwent CABG.
本研究旨在探讨 14 种促血管生成 microRNAs(miRNAs)与行冠状动脉旁路移植术(CABG)的无保护左主干冠状动脉疾病(ULMCAD)患者主要不良心脑血管事件(MACCE)发生的相关性。
共纳入 196 例行首次 CABG 的 ULMCAD 患者。在 CABG 前采集外周血样,然后分离血浆样本,通过逆转录定量 PCR 检测 14 种促血管生成 miRNA 的表达。对患者进行定期随访,直至 MACCE 发生或 CABG 后 36 个月。
1 年、2 年和 3 年的 MACCE 发生率分别为 7.1%、11.2%和 14.3%,累积 MACCE 发生时间为 32.7(95%置信区间:31.5-33.9)个月。Kaplan-Meier 曲线和单因素 Cox 回归分析均显示,miR-let-7f、miR-19a、miR-126、miR-130a 和 miR-378 高表达与较低的累积 MACCE 发生率相关。进一步的向前逐步多因素 Cox 回归分析显示,miR-let-7f 高表达和 miR-378 高表达独立预测累积 MACCE 发生率降低,而 BMI(>25.0kg/m2)、糖尿病、既往卒中以及更高的疾病严重程度是累积 MACCE 发生率升高的独立预测因素。
检测循环促血管生成 miRNA,特别是 miR-let-7f、miR-19a、miR-126、miR-130a 和 miR-378,有助于预测行 CABG 的 ULMCAD 患者的 MACCE 风险。