Wang Guan, Wang Chun, Huang Zhengyi, Sun Shuai, Chen Yanjun
Department of Cardiology, Peking University Shenzhen Hospital, Shenzhen, 518036, China.
Department of Geriatrics, Shenzhen Longhua District Central Hospital, Shenzhen, 518110, China.
Open Med (Wars). 2023 Oct 11;18(1):20230807. doi: 10.1515/med-2023-0807. eCollection 2023.
This study attempted to identify exosomal circular RNAs (circRNAs) as diagnostic and prognostic biomarkers for patients with ST-segment elevation myocardial infarction (STEMI). The differentially expressed exosomal circRNAs (DEECs) were screened from microarray dataset (GSE160717 and GSE197137) and RNA-Seq dataset (GSE208194), and the expression levels of DEECs in patients with STEMI were validated using reverse transcription and quantitative real-time PCR. The diagnostic value of DEECs was assessed using receiver operating characteristic curves. The major adverse cardiovascular event (MACE)-free 1-year survival rate was evaluated using the Kaplan-Meier method, and the factors affecting prognosis were determined using Cox regression model analysis. Results showed that four DEECs were screened including exo-circ-0001490, exo-circ-0020887, exo-circ-0009590, and exo-circ-0055440, and only upregulated exo-circ-0020887 and exo-circ-0009590 expression was validated in patients with STEMI. The exo-circ-0020887 and exo-circ-0009590 expression was positively correlated with hs-CRP, LDL-C, cTnI, and CK-MB. The exo-circ-0020887 and exo-circ-0009590 showed good diagnostic efficacy to distinguish STEMI patients from healthy controls (area under the curves: 0.85 and 0.80). STEMI patients with high levels of exo-circ-0020887 and exo-circ-0009590 had lower MACE-free 1-year survival rate, and exo-circ-0020887 and exo-circ-0009590 expression was independent risk factors for adverse prognosis. In summary, upregulation of plasma exo-circ-0020887 and exo-circ-0009590 might act as potential biomarkers for the diagnosis and prediction of short-term adverse cardiovascular outcomes in patients with STEMI.
本研究试图鉴定外泌体环状RNA（circRNA）作为ST段抬高型心肌梗死（STEMI）患者的诊断和预后生物标志物。从微阵列数据集（GSE160717和GSE197137）和RNA测序数据集（GSE208194）中筛选差异表达的外泌体circRNA（DEEC），并使用逆转录和定量实时PCR验证STEMI患者中DEEC的表达水平。使用受试者工作特征曲线评估DEEC的诊断价值。采用Kaplan-Meier法评估无主要不良心血管事件（MACE）的1年生存率，并使用Cox回归模型分析确定影响预后的因素。结果显示，筛选出4种DEEC，包括外泌体circ-0001490、外泌体circ-0020887、外泌体circ-0009590和外泌体circ-0055440，且仅在STEMI患者中验证了上调的外泌体circ-0020887和外泌体circ-0009590的表达。外泌体circ-0020887和外泌体circ-0009590的表达与hs-CRP、LDL-C、cTnI和CK-MB呈正相关。外泌体circ-0020887和外泌体circ-0009590在区分STEMI患者和健康对照方面显示出良好的诊断效能（曲线下面积分别为0.85和0.80）。外泌体circ-0020887和外泌体circ-0009590水平高的STEMI患者无MACE的1年生存率较低，且外泌体circ-0020887和外泌体circ-0009590的表达是不良预后的独立危险因素。总之，血浆外泌体circ-0020887和外泌体circ-0009590的上调可能作为STEMI患者诊断和预测短期不良心血管结局的潜在生物标志物。
