Clinical Laboratory, The Affiliated Hospital of Chengde Medical University, Chengde, Hebei, China.
Heart Vessels. 2023 Mar;38(3):318-331. doi: 10.1007/s00380-022-02172-2. Epub 2022 Oct 10.
Acute myocardial infarction (AMI) is one of the most serious complications of coronary heart disease. Although morbidity and mortality have been decreasing year by year, acute coronary syndrome still has a high mortality rate and disability rate. To search for accurate and effective biomarkers, we explore the diagnostic and prognostic value of microRNAs (miRNAs) and the monocyte to high-density lipoprotein cholesterol ratio (MHR) in patients with AMI. By referring to the relevant literature, miR-486-5p, miR-451a and miR-21-5p were reportedly altered in the blood of patients with ischemic heart disease. These miRNAs were selected and validated in 40 AMI patients, 22 unstable angina pectoris (UAP) and 22 healthy groups (HC) by real-time fluorescent quantitative polymerase chain reaction (RT-qPCR). All patients with AMI underwent primary percutaneous coronary intervention (PCI) and were followed up 3 months after the operation. MHR and miR-451a expression were markedly elevated in plasma samples of AMI patients compared with the UAP and HC groups, but the expressions of miR-486-5p and miR-21-5p were significantly decreased. The expression level of miRNA-451a increased gradually among the three groups (p < 0.05). However, the expression of miRNA-21-5p showed a downward trend (p < 0.05). More importantly, MHR was significantly different before and after PCI in AMI patients (p < 0.05). Receiver operating characteristic (ROC) analysis indicated that MHR, miR-486-5p, miR-451a and miR-21-5p could diagnose and predict AMI. MiR-451a was a more reliable biomarker for AMI diagnosis among these miRNAs. Moreover, the combination of MHR and miRNAs had higher diagnostic value for AMI. We further demonstrated that miR-21-5p had a strong predictive ability for the occurrence of major adverse cardiovascular events (MACE) after 3 months. The results showed that circulating miR-486-5p, miR-451a, miR-21-5p and MHR may play critical roles in the early phase of AMI, and may be used as potential predictors for AMI diagnosis. Importantly, miR-451a was a more reliable biomarker in diagnosing AMI patients. Circulating miR-21-5p may be used as a predictor of MACE occurrence.
急性心肌梗死（AMI）是冠心病最严重的并发症之一。尽管发病率和死亡率逐年下降，但急性冠状动脉综合征的死亡率和致残率仍然很高。为了寻找准确有效的生物标志物，我们探讨了 microRNAs（miRNAs）和单核细胞与高密度脂蛋白胆固醇比值（MHR）在 AMI 患者中的诊断和预后价值。通过查阅相关文献，报道 miR-486-5p、miR-451a 和 miR-21-5p 在缺血性心脏病患者的血液中发生改变。通过实时荧光定量聚合酶链反应（RT-qPCR），我们在 40 例 AMI 患者、22 例不稳定型心绞痛（UAP）患者和 22 例健康对照组（HC）中选择和验证了这些 miRNA。所有 AMI 患者均行直接经皮冠状动脉介入治疗（PCI），术后 3 个月进行随访。与 UAP 和 HC 组相比，AMI 患者的血浆样本中 MHR 和 miR-451a 的表达明显升高，而 miR-486-5p 和 miR-21-5p 的表达明显降低。miRNA-451a 的表达水平在三组中逐渐升高（p<0.05）。然而，miR-21-5p 的表达呈下降趋势（p<0.05）。更重要的是，AMI 患者 PCI 前后 MHR 差异有统计学意义（p<0.05）。受试者工作特征（ROC）分析表明，MHR、miR-486-5p、miR-451a 和 miR-21-5p 可用于诊断和预测 AMI。在这些 miRNA 中，miR-451a 是诊断 AMI 的更可靠的生物标志物。此外，MHR 和 miRNAs 的联合具有更高的 AMI 诊断价值。我们进一步证明，miR-21-5p 对 3 个月后主要不良心血管事件（MACE）的发生具有较强的预测能力。结果表明，循环 miR-486-5p、miR-451a、miR-21-5p 和 MHR 可能在 AMI 的早期阶段发挥重要作用，并可能作为 AMI 诊断的潜在预测指标。重要的是，miR-451a 是诊断 AMI 患者更可靠的生物标志物。循环 miR-21-5p 可作为 MACE 发生的预测指标。
