血小板衍生的环状FAM13B与急性冠脉综合征患者替格瑞洛的抗血小板反应性相关。

Platelet-derived circFAM13B associated with anti-platelet responsiveness of ticagrelor in patients with acute coronary syndrome.

作者信息

Zou Yuting, Wang Yuyan, Yao Yanzhu, Wu Yangxun, Lv Chao, Yin Tong

机构信息

Institute of Geriatrics, National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, Beijing, China.

Senior Department of Cardiology, The 6th Medical Center, Chinese PLA General Hospital, Beijing, China.

出版信息

Thromb J. 2024 Jun 21;22(1):53. doi: 10.1186/s12959-024-00620-9.

DOI:10.1186/s12959-024-00620-9

PMID:38907258

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11191304/

Abstract

BACKGROUND

Platelet is enriched with Circular RNAs (circRNAs), with circFAM13B rank among the 10 most abundant circRNAs in platelets. The aim of the present study was to evaluate the predictive value of platelet-derived circFAM13B for the antiplatelet responsiveness and efficacy of ticagrelor in patients with acute coronary syndrome (ACS).

METHODS

Consecutive ACS patients treated with ticagrelor were enrolled, and the antiplatelet responsiveness of 3 days of ticagrelor maintenance treatment was assessed by measuring the adenosine diphosphate (ADP)-induced platelet inhibition rate (ADP%) using thromboelastography. The expression of circFAM13B in the patients' platelets was analyzed by quantitative real-time polymerase chain reaction. The correlation between circFAM13B expression and ticagrelor antiplatelet responsiveness, as well as the independent contribution of circFAM13B to the composite of adverse ischemic events during a follow-up period of at least 12 months was evaluated.

RESULTS

A total of 129 eligible ACS patients treated with ticagrelor were enrolled in the study. A negative correlation was found between the expression of circFAM13B and the ADP% value (r = -0.41, P < 0.001). Patients with ADP% ≥ 76% had a significantly lower level of circFAM13B compared to those with ADP% < 76% (adjusted P = 0.009). Receiver operating characteristic curve analysis demonstrated that combining circFAM13B expression > 1.05 with clinical risk factors could effectively predict the risk of adverse ischemic events (AUC = 0.81, 95% CI: 0.69 to 0.92, P < 0.001). Kaplan-Meier survival analysis showed that patients with circFAM13B > 1.05 had a significantly higher risk of adverse ischemic events compared to those with circFAM13B ≤ 1.05 (P = 0.003). Multivariate logistic hazard analysis identified circFAM13B > 1.05 as an independent risk factor for adverse ischemic events in in ticagrelor-treated ACS patients (adjusted OR: 5.60, 95% CI: 1.69-18.50; P = 0.005).

CONCLUSIONS

Platelet-derived circFAM13B could be utilized for predicting the antiplatelet responsiveness and efficacy of ticagrelor in patients with ACS.

摘要

背景

血小板富含环状RNA（circRNA），circFAM13B是血小板中含量排名前十的circRNA之一。本研究旨在评估血小板源性circFAM13B对急性冠状动脉综合征（ACS）患者替格瑞洛抗血小板反应性及疗效的预测价值。

方法

纳入接受替格瑞洛治疗的连续性ACS患者，采用血栓弹力图测量二磷酸腺苷（ADP）诱导的血小板抑制率（ADP%），评估替格瑞洛维持治疗3天的抗血小板反应性。通过定量实时聚合酶链反应分析患者血小板中circFAM13B的表达。评估circFAM13B表达与替格瑞洛抗血小板反应性之间的相关性，以及circFAM13B对至少12个月随访期内不良缺血事件复合终点的独立贡献。

结果

本研究共纳入129例接受替格瑞洛治疗的合格ACS患者。发现circFAM13B表达与ADP%值呈负相关（r = -0.41，P < 0.001）。与ADP% < 76%的患者相比，ADP%≥76%的患者circFAM13B水平显著更低（校正P = 0.009）。受试者工作特征曲线分析表明，将circFAM13B表达> 1.05与临床危险因素相结合可有效预测不良缺血事件风险（AUC = 0.81，95%CI：0.69至0.92，P < 0.001）。Kaplan-Meier生存分析显示，与circFAM13B≤1.05的患者相比，circFAM13B> 1.05的患者发生不良缺血事件的风险显著更高（P = 0.003）。多因素逻辑风险分析确定circFAM13B> 1.05是替格瑞洛治疗的ACS患者发生不良缺血事件的独立危险因素（校正OR：5.60，95%CI：1.69 - 18.50；P = 0.005）。