Eyileten Ceren, Skrobucha Alicja, Starczyński Miłosz, Boszko Maria, Jarosz-Popek Joanna, Fitas Alex, Filipiak Krzysztof J, Kochman Janusz, Huczek Zenon, Rymuza Bartosz, Wilimski Radosław, Kuśmierczyk Mariusz, Siller-Matula Jolanta M, Postula Marek, Gąsecka Aleksandra
Department of Experimental and Clinical Pharmacology, Center for Preclinical Research and Technology, Medical University of Warsaw, Poland.
1st Chair and Department of Cardiology, Medical University of Warsaw, Poland.
Cardiol J. 2024;31(1):111-123. doi: 10.5603/CJ.a2022.0090. Epub 2022 Oct 6.
Transcatheter aortic valve implantation (TAVI) is an established treatment for aortic stenosis (AS) in patients at increased surgical risk. Up to 29% of patients annually experience major adverse cardiac and cerebrovascular events (MACCE) after TAVI. MicroRNAs (miRNA) are currently widely investigated as novel cardiovascular biomarkers. The aim of this study was to determine the influence of TAVI on the expressions of selected miRNAs associated with platelet function (miR-125a-5p, miR-125b and miR-223), and evaluate the predictive value of these miRNAs for MACCE in 65 patients undergoing TAVI.
Venous blood samples for miRNA expression analysis were collected 1 day before TAVI and at hospital discharge. The expression of miR-223, miR-125a-5p, miR-125b was evaluated in platelet-depleted plasma.
The expression of miR-223 and miR-125b increased after TAVI, compared to the measurement before (p = 0.020, p = 0.003, respectively). Among 63 patients discharged from the hospital, 18 patients experienced MACCE (29%) during the median 15 months of observation. Baseline low miR-223 expression was a predictor of MACCE in univariate Cox regression analysis (hazard ratio [HR]: 2.71, 95% confidence interval [CI]: 1.04-7.01; p = 0.041). After inclusion of covariates, age, gender (male), New York Heart Association class and diabetes into the multivariate Cox regression model, miR-223 did not reach statistical significance (HR: 2.56, 95% CI: 0.79-8.33; p = 0.118).
To conclude, miR-223 might improve risk stratification after TAVI. Further studies are required to confirm the clinical applicability of this promising biomarker.
经导管主动脉瓣植入术（TAVI）是手术风险增加的主动脉瓣狭窄（AS）患者的既定治疗方法。每年高达29%的患者在TAVI术后发生主要不良心脑血管事件（MACCE）。微小RNA（miRNA）目前作为新型心血管生物标志物受到广泛研究。本研究的目的是确定TAVI对与血小板功能相关的选定miRNA（miR-125a-5p、miR-125b和miR-223）表达的影响，并评估这些miRNA对65例行TAVI患者MACCE的预测价值。
在TAVI术前1天和出院时采集用于miRNA表达分析的静脉血样本。在无血小板血浆中评估miR-223、miR-125a-5p、miR-125b的表达。
与术前测量相比，TAVI术后miR-223和miR-125b的表达增加（分别为p = 0.020，p = 0.003）。在63例出院患者中，18例（29%）在中位15个月的观察期内发生MACCE。在单变量Cox回归分析中，基线miR-223低表达是MACCE的预测因素（风险比[HR]：2.71，95%置信区间[CI]：1.04 - 7.01；p = 0.041）。将协变量年龄、性别（男性）、纽约心脏协会分级和糖尿病纳入多变量Cox回归模型后，miR-223未达到统计学意义（HR：2.56，95% CI：- 0.79 - 8.33；p = 0.118）。
总之，miR-223可能改善TAVI术后的风险分层。需要进一步研究以证实这种有前景的生物标志物的临床适用性。
