循环MicroRNA-208b对急性心肌梗死近期临床预后的影响

The effect of circulating microRNA-208b on short-term prognosis of acute myocardial infarction

目的:探讨循环MicroRNA-208b(miR-208b)对急性心肌梗死(acute myocardial infarction,AMI)患者近期临床预后的影响。方法:随机连续性纳入2018年4月~2019年3月就诊于我院心血管内科的明确诊断为AMI的患者共120例,入院即刻检测所有患者外周血循环miR-208b、CK-MB及cTnI水平。所有受试者均予最优治疗后好转出院,随访其出院后6个月内主要不良心血管事件(major adverse cardiovascular events,MACE)发生情况。其中27例患者随访过程中出现MACE,归为MACE组,余下93例未发生MACE归为非MACE组,比较两组患者miR-208b水平的差异,应用受试者工作特征曲线(ROC)评估miR-208b对MACE的预测价值,同时应用Kaplan-Meier比较miR-208b水平高低对无MACE生存率的影响。结果:本研究发现,miR-208b在MACE组中的表达水平显著高于非MACE组,同时Pearson相关分析表明miR-208b与cTnI两者之间为正相关关系;此外,ROC曲线发现miR-208b可以作为预测MACE的指标,其曲线下面积(AUC)(95%CI)为0.84(0.75-0.94),最佳诊断界值为3.18,Kaplan-Meier生存分析发现,miR-208b>3.18的患者MACE的发生更高。结论:循环miR-208b是预测AMI近期临床预后的潜在指标。

Objective To investigate the effect of circulating microRNA-208b(miR-208b)on short-term clinical outcome in patients with acute myocardial infarction(AMI).Methods 120 AMI patients were collected randomly and continuity who admitted to cardiology departments in our hospital April 2018 to March 2019,and all of them were collected intravenous blood to detect levels of miR-208b,CK-MB and cTnI on admission and were followed-up within 6 months after discharge to record major adverse cardiovascular events(MACE).27 AMI patients with MACE were classified as MACE group and 90 patients without MACE severed as non-MACE group.The differences in level of miR-208b between two groups were compared,meanwhile,the value of miR-208b for short-term prognosis of AMI patients by using receiver operating characteristic curve(ROC),and Kaplan-Meier was used to compare the effect of miR-208b on the survival rate without MACE.Results Compared with non-MACE group,AMI patients with MACE had higher level of miR-208b,and it had a positive relationship between miR-208b and cTnI;what’s more,miR-208b was a biomarker for the prognosis of AMI,the AUC(95%CI)was 0.84(0.75-0.94)and the optimal diagnostic cut-off was 3.18,furthermore,AMI patients with miR-208b>3.18 had a higher incidence of MACE.Conclusion Circulating miR-208b was a potential biomarker for predicting the short-term prognosis of AMI in the near future.