血清miR-150检测对冠心病患者PCI术后发生不良心血管事件的预测价值

Predictive value of detecting serum miR-150 for MACE in patients with coronary heart disease after PCI

目的探讨血清微小RNA-150(miR-150)检测对冠心病患者经皮冠状动脉介入治疗(PCI)术后发生不良心血管事件(MACE)的预测价值。方法选择行急诊PCI的冠心病患者153例,根据术后6个月内有无MACE发生分为MACE组(n=31)、非MACE组(n=122);同期随机选取80例年龄、性别与冠心病患者匹配的健康体检者为对照组。采用实时荧光定量PCR(RT-qPCR)法检测各组血清miR-150,收集各组临床资料,术后对冠心病患者进行定期随访。绘制受试者工作特征曲线,用曲线下面积(AUC)评估血清miR-150对冠心病患者PCI术后6个月内发生MACE的预测价值。结果与非MACE组比较,MACE组心肌梗死比例高,病变严重(P均<0.05)。与对照组比较,MACE组、非MACE组TC、LDL-C高,LVEF、miR-150相对表达量低(P均<0.05);与非MACE组比较,MACE组TC、LDL-C高,LVEF、miR-150相对表达量低(P均<0.05)。多因素Logistic回归模型分析结果显示,心肌梗死、冠状动脉中度病变、冠状动脉重度病变、TC升高、LDL-C升高是冠心病患者PCI术后发生MACE的独立危险因素(OR分别为1.660、1.235、1.640、1.225、1.211,P均<0.05),LVEF升高、miR-150升高是保护因素(OR分别为0.925、0.732,P均<0.05)。miR-150预测冠心病患者PCI术后发生MACE的AUC为0.882(95%CI:0.832~0.933,P=0.000),最佳截断值为0.37,约登指数为0.71,此时的灵敏度、特异度分别为83.87%(26/31)、86.89%(106/122),正确率为86.27%(132/153)。结论血清miR-150可作为预测冠心病患者PCI术后6个月内发生MACE的指标之一。

Objective To explore the predictive value of detecting serum microRNA-150(miR-150)for the occurrence of major adverse cardiovascular events(MACE)after percutaneous coronary intervention(PCI)in patients with coronary heart disease.Methods Totally 153 patients with coronary heart disease undergoing emergency PCI were divided into the MACE group(n=31)and non-MACE group(n=122)according to whether MACE occurred within 6 months after PCI.At the same time,80 healthy volunteers with age and gender matched with coronary heart disease patients were randomly selected as the control group.The serum miR-150 was measured by the real-time quantitative PCR(RT-qPCR).Clinical date of each group were collected,and patients with coronary heart disease were followed up regularly after operation.The area under the receiver operating characteristic(ROC)curve was drawn to evaluate the predictive value of serum miR-150 on the risk of MACE in patients with coronary heart disease within 6 months after PCI.Results Compared with the non-MACE group,the proportion of myocardial infarction in the MACE group was higher and the lesions were more serious(all P<0.05).Compared with the control group,the levels of TC and LDL-C in the MACE group and non-MACE group were higher,and LVEF and miR-150 relative expression were lower(all P<0.05);compared with the non-MACE group,the TC and LDL-C levels in the MACE group were higher,and LVEF and miR-150 relative expression were lower(both P<0.05).Multivariate logistic regression model analysis showed that myocardial infarction,moderate coronary artery disease,severe coronary artery disease,elevated TC and elevated LDL-C were independent risk factors for MACE in patients with coronary heart disease after PCI(OR=1.660,1.235,1.640,1.225,1.211,respectively;all P<0.05),elevated LVEF and high miR-150 were protective factors for MACE in patients with coronary heart disease after PCI(OR=0.925,0.732,respectively;both P<0.05).The AUC of miR-150 in predicting MACE after PCI in patients with coronary heart disease was 0.882(95%CI:0.832-0.933,P=0.000),the cut-off value was 0.37,the Youden index was 0.71,the sensitivity and specificity were 83.87%(26/31)and 86.89%(106/122),and the correct rate was 86.27%(132/153).Conclusion Serum miR-150 can be used as a predictor of MACE in patients with coronary heart disease within 6 months after PCI.