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ST段抬高型心肌梗死患者全血中的血小板功能、成熟度及相关微小RNA表达

Platelet Function and Maturity and Related microRNA Expression in Whole Blood in Patients with ST-Segment Elevation Myocardial Infarction.

作者信息

Pedersen Oliver Buchhave, Hvas Anne-Mette, Pasalic Leonardo, Kristensen Steen Dalby, Grove Erik Lerkevang, Nissen Peter H

机构信息

Thrombosis and Haemostasis Research Unit, Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus, Denmark.

Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark.

出版信息

Thromb Haemost. 2024 Mar;124(3):192-202. doi: 10.1055/s-0043-1776305. Epub 2023 Oct 16.

Abstract

BACKGROUND

Reduced effect of antiplatelet therapy has been reported in patients with ST-segment elevation myocardial infarction (STEMI). MicroRNAs (miRs) may influence platelet function and maturity, and subsequently the effect of antiplatelet therapy.

OBJECTIVES

We aimed to explore the association between miR expression and platelet function and maturity in patients with acute STEMI and healthy individuals.

METHODS

We performed an observational study of STEMI patients admitted directly to primary percutaneous coronary intervention. Patients were treated with antiplatelet therapy according to guidelines. Within 24 hours after admission, blood samples were obtained to measure: the expression of 10 candidate miRs, platelet function markers using advanced flow cytometry, platelet aggregation, serum thromboxane B, and platelet maturity markers. Furthermore, blood samples from healthy individuals were obtained to determine the normal variation.

RESULTS

In total, 61 STEMI patients and 50 healthy individuals were included. STEMI patients had higher expression of miR-21-5p, miR-26b-5p, and miR-223-3p and lower expression of miR-150-5p, miR423-5p, and miR-1180-3p than healthy individuals. In STEMI patients, the expression of miR-26b-5p showed the most consistent association with platelet function (all -values <0.05, Spearman's rho ranging from 0.27 to 0.41), while the expression of miR-150-5p and miR-223-3p showed negative associations with platelet function. No association between miR expression and platelet maturity markers was observed.

CONCLUSION

In patients with STEMI, the expression of six miRs was significantly different from healthy individuals. The expression of miR-26b-5p may affect platelet function in acute STEMI patients and potentially influence the effect of antiplatelet therapy.

摘要

背景

已有报道称ST段抬高型心肌梗死(STEMI)患者抗血小板治疗效果降低。微小RNA(miR)可能影响血小板功能和成熟度,进而影响抗血小板治疗的效果。

目的

我们旨在探讨急性STEMI患者和健康个体中miR表达与血小板功能及成熟度之间的关联。

方法

我们对直接接受急诊经皮冠状动脉介入治疗的STEMI患者进行了一项观察性研究。患者按照指南接受抗血小板治疗。入院后24小时内采集血样,检测:10种候选miR的表达、使用先进流式细胞术检测血小板功能标志物、血小板聚集、血清血栓素B以及血小板成熟标志物。此外,采集健康个体的血样以确定正常变异情况。

结果

共纳入61例STEMI患者和50例健康个体。与健康个体相比,STEMI患者中miR-21-5p、miR-26b-5p和miR-223-3p表达较高,而miR-150-5p、miR423-5p和miR-1180-3p表达较低。在STEMI患者中,miR-26b-5p的表达与血小板功能的关联最为一致(所有P值<0.05,Spearman相关系数范围为0.27至0.41),而miR-150-5p和miR-223-3p的表达与血小板功能呈负相关。未观察到miR表达与血小板成熟标志物之间的关联。

结论

在STEMI患者中,6种miR的表达与健康个体存在显著差异。miR-26b-5p的表达可能影响急性STEMI患者的血小板功能,并可能影响抗血小板治疗的效果。

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