Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University; Beijing-China.
Department of Outpatient, Beijing Friendship Hospital, Capital Medical University; Beijing-China.
Anatol J Cardiol. 2021 May;25(5):323-329. doi: 10.14744/AnatolJCardiol.2020.29267.
This study aims to investigate the association of circulating miR-660-5p with no-reflow phenomenon (NRP) in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).
Consecutive patients diagnosed with anterior STEMI within 12 h of pain onset were included; in these patients, coronary angiography confirmed that the left anterior descending artery was infarcted. Angiographic NRP was defined as a final thrombolysis in myocardial infarction (TIMI) flow 2 or 3 with a myocardial blush grade (MBG) <2. High miR-660-5p was defined as a value in the third tertile. The relationship of circulating miR-660-5p with NRP was assessed using Spearman correlation analysis and multiple logistic regression analysis.
Fifty-two eligible patients were finally included in this study (mean age: 56±12.4 years, >65 years: 53.8%, male: 76.9%, and mean Body Mass Index: 26.3±3.5). The incidence of NRP was 38.5%. Circulating miR-660-5p was significantly related to the mean platelet volume (MPV). The patients were grouped into tertiles by miR-660-5p levels (Q1: <7.18, Q2: 7.18-11.31, Q3: >11.31). Those in the high microRNA-660-5p group had nearly a 6-fold higher risk of NRP than those in the low microRNA-660-5p group [odds ratio (OR) = 5.68, 95% confidence interval (CI) 1.40-23.07, p=0.015]. When analyzed by tertiles, relative odds of NRP were consistently increasing (OR1 for Q2 vs. Q1: 1.25, 95% CI: 0.27-5.73, p=0.770; OR2 for Q3 vs. Q1: 5.96, 95% CI: 1.33-26.66, p=0.02), despite multivariable adjustment. Receiver operating characteristic curve analysis demonstrated that the microRNA-660-5p level of 10.17 was the best cut-off level to predict the incidence of the NRP in patients undergoing PPCI with an area under the ROC curve (AUC) of 0.768 (95% CI: 0.636-0.890).
Circulating miR-660-5p was significantly associated with NRP, and it may be a useful biomarker to predict the incidence of NRP in patients with STEMI undergoing PPCI.
本研究旨在探讨循环 miR-660-5p 与接受直接经皮冠状动脉介入治疗（PPCI）的 ST 段抬高型心肌梗死（STEMI）患者无复流现象（NRP）之间的关系。
纳入胸痛发作后 12 小时内确诊为前壁 STEMI 的连续患者；这些患者的冠状动脉造影证实左前降支梗死。血管造影 NRP 定义为最终血栓溶解心肌梗死（TIMI）血流 2 或 3 级，心肌灌注分级（MBG）<2。高 miR-660-5p 定义为第 3 个三分位值。采用 Spearman 相关分析和多因素 logistic 回归分析评估循环 miR-660-5p 与 NRP 的关系。
本研究最终纳入 52 例符合条件的患者（平均年龄：56±12.4 岁，>65 岁：53.8%，男性：76.9%，平均体重指数：26.3±3.5）。NRP 的发生率为 38.5%。循环 miR-660-5p 与平均血小板体积（MPV）显著相关。根据 miR-660-5p 水平将患者分为三分位组（Q1：<7.18，Q2：7.18-11.31，Q3：>11.31）。高 microRNA-660-5p 组的 NRP 风险几乎是低 microRNA-660-5p 组的 6 倍[优势比（OR）=5.68，95%置信区间（CI）1.40-23.07，p=0.015]。按三分位分析，NRP 的相对优势比持续增加（OR1 与 Q2 相比 Q1：1.25，95%CI：0.27-5.73，p=0.770；OR2 与 Q3 相比 Q1：5.96，95%CI：1.33-26.66，p=0.02），尽管进行了多变量调整。受试者工作特征曲线分析表明，miR-660-5p 水平为 10.17 是预测行 PPCI 的 STEMI 患者 NRP 发生率的最佳截断值，ROC 曲线下面积（AUC）为 0.768（95%CI：0.636-0.890）。
循环 miR-660-5p 与 NRP 显著相关，可能是预测 STEMI 患者行 PPCI 后 NRP 发生率的有用生物标志物。
