Zhao J W, Yu H Y, Zhang Y Z, Gao W
Department of Cardiology and Institute of Vascular Medicine, Peking University Third Hospital; NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides; Key Laboratory of Molecular Cardiovascular Science, Ministry of Education; Beijing Key Laboratory of Cardiovascular Receptors Research, Beijing 100191, China.
Zhonghua Yi Xue Za Zhi. 2023 Mar 28;103(12):901-906. doi: 10.3760/cma.j.cn112137-20220810-01722.
To investigate the expression level and clinical significance of cSMARCA5 in the patients with acute myocardial infarction (AMI). This study was a case-control study. A total of 100 patients with AMI and 100 patients without coronary heart disease who received treatment in the Department of Cardiology, Peking University Third Hospital from September to December 2021 were included in the study according to the principle of 1∶1 frequency matching. The expression levels of cSMARCA5 in the peripheral blood of AMI patients and control groups were measured by real-time quantitative polymerase chain reaction (RT-qPCR). The receiver operating characteristic (ROC) curve was used to calculate the diagnostic ability of cSMARCA5 for AMI. Spearman or Pearson correlation analysis was used to explore the correlation between cSMARCA5 and the degree of myocardial necrosis, coronary lesion severity and GRACE risk stratification score. Bioinformatics analysis was used to predict the possible mechanism of cSMARCA5 in pathological changes of AMI. The age [ (,)] of AMI patients and control group was 63.0 (56.0, 71.5) and 63.0 (53.0, 75.5) (=0.622), and the proportion of males was 75.0% (75 cases) and 46.0% (46 cases) (<0.001), respectively. The expression level [ (,)] of cSMARCA5 was significantly lower in AMI patients compared with the control group [0.37 (0.22, 0.73) vs 1.03(0.71, 1.75), <0.001]. ROC analysis showed that the area under the curve of cSMARCA5 in diagnosing AMI was 0.83 (95%: 0.77-0.89, <0.001), with a sensitivity of 89.0% and specificity of 67.7%. cSMARCA5 was negatively correlated with creatine kinase isoenzyme MB (=-0.203, =0.041), troponin T (=-0.230, =0.023) and N-terminal brain natriuretic peptide precursor (=-0.250, =0.012), and positively correlated with left ventricular ejection fraction (=0.201, =0.042). In addition, the expression level of cSMARCA5 was negatively correlated with SYNTAX score (=-0.196, =0.048) and GRACE risk score (=-0.321, =0.001). Bioinformatic analysis suggested that cSMARCA5 might be involved in the process of AMI through regulating the gene expression of tumor necrosis factor. The expression of cSMARCA5 is significantly decreased in peripheral blood of AMI patients compared with control group, and its expression level is negatively correlated with the severity of myocardial infarction. cSMARCA5 is expected to be a potential biomarker of AMI.
探讨cSMARCA5在急性心肌梗死（AMI）患者中的表达水平及临床意义。本研究为病例对照研究。按照1∶1频数匹配原则，纳入2021年9月至12月在北京大学第三医院心内科接受治疗的100例AMI患者和100例无冠心病患者。采用实时定量聚合酶链反应（RT-qPCR）检测AMI患者和对照组外周血中cSMARCA5的表达水平。采用受试者操作特征（ROC）曲线计算cSMARCA5对AMI的诊断能力。采用Spearman或Pearson相关分析探讨cSMARCA5与心肌坏死程度、冠状动脉病变严重程度及GRACE危险分层评分之间的相关性。采用生物信息学分析预测cSMARCA5在AMI病理变化中的可能机制。AMI患者和对照组的年龄[（，）]分别为63.0（56.0，71.5）和63.0（53.0，75.5）（=0.622），男性比例分别为75.0%（75例）和46.0%（46例）（<0.001）。与对照组相比，AMI患者cSMARCA5的表达水平[（，）]显著降低[0.37（0.22，0.73） vs 1.03（0.71，1.75），<0.001]。ROC分析显示，cSMARCA5诊断AMI的曲线下面积为0.83（95%：0.77 - 0.89，<0.001），灵敏度为89.0%，特异度为67.7%。cSMARCA5与肌酸激酶同工酶MB（=-0.203，=0.041）、肌钙蛋白T（=-0.230，=0.023）和N末端脑钠肽前体（=-0.250，=0.012）呈负相关，与左心室射血分数呈正相关（=0.201，=0.042）。此外，cSMARCA5的表达水平与SYNTAX评分（=-0.196，=0.048）和GRACE危险评分（=-0.321，=0.001）呈负相关。生物信息学分析表明，cSMARCA5可能通过调节肿瘤坏死因子的基因表达参与AMI的发生过程。与对照组相比，AMI患者外周血中cSMARCA5的表达显著降低，其表达水平与心肌梗死严重程度呈负相关。cSMARCA5有望成为AMI的潜在生物标志物。
