血清miR-647 PTEN与ACS患者PCI术后支架内再狭窄的关系

Association of Serum miR-647 PTEN and In-Stent Restenosis After PCI in Patients with ACS

目的:探讨血清微小RNA(miRNA)-647、第10号染色体缺失的磷酸酶和张力蛋白同源基因(PTEN)与急性冠状动脉综合征(ACS)患者经皮冠状动脉介入治疗(PCI)术后支架内再狭窄的关系。方法:209例ACS患者,根据PCI术后1年是否发生支架内再狭窄为再狭窄组(n=45)和无再狭窄组(n=164),qPCR和ELISA检测血清miR-647,PTEN水平。Pearson相关性分析ACS患者血清miR-647与PTEN水平的相关性。多因素Logistic回归分析ACS患者PCI术后支架内再狭窄影响因素,ROC曲线分析血清miR-647,PTEN水平对ACS患者PCI术后支架内再狭窄的预测价值。结果:与无再狭窄组比较,再狭窄组miR-647水平升高,PTEN水平降低(P<0.05)。ACS患者血清miR-647与PTEN水平呈负相关(r=-0.701,P<0.001)。支架内径、Gensini积分、PTEN为PCI术后支架内再狭窄独立保护因素,miR-647为独立危险因素(P<0.05)。血清miR-647,PTEN水平最佳截断值分别为0.91,2.53ng/mL时,单独及联合预测PCI术后支架内再狭窄的AUC分别为0.768,0.790,0.866,敏感度分别为66.67%,64.44%,77.78%,特异度分别为72.56%,81.10%,83.54%。miR-647+PTEN预测ACS患者PCI术后支架内再狭窄的AUC大于miR-647,PTEN单独预测(P<0.05)。结论:PCI术后支架内再狭窄ACS患者血清miR-647水平升高,PTEN水平降低,二者可能共同参与支架内再狭窄,可作为支架内再狭窄预测指标。

Objective:To investigate the association of serum microRNA(miRNA)-647,phosphatase and tensin homolog deleted on chromosome ten(PTEN)with in-stent restenosis after percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods:A total of 209 patients with ACS were divided into restenosis group(n=45)and non-restenosis group(n=164)according to whether in-stent restenosis occurred 1 year after PCI,whose serum miR-647 and PTEN levels were measured by qPCR and ELISA.Pearson correlation was used to analyze the correlation between serum miR-647 and PTEN levels in ACS patients,multifactor Logistic regression to analyze the factors influencing in-stent restenosis after PCI in ACS patients,and ROC to analyze the predictive value of serum miR-647 and PTEN levels on in-stent restenosis after PCI in ACS patients.Results:Compared with the non-restenosis group,miR-647 levels increased and PTEN levels decreased in the restenosis group(P<0.05).Serum miR-647 in ACS patients was negatively correlated with PTEN levels(r=-0.701,P<0.001).Stent internal diameter,Gensini integral and PTEN were independent protective factors for in-stent restenosis after PCI,and miR-647 was an independent risk factor(P<0.05).The AUCs for predicting in-stent restenosis after PCI were 0.768,0.790 and 0.866 for serum miR-647 and PTEN levels at optimal cut-off values of 0.91 and 2.53 ng/mL,respectively,with sensitivities of 66.67%,64.44%and 77.78%and specificities of 72.56%,81.10%and 83.54%.miR-647+PTEN predicted greater AUC than miR-647 for in-stent restenosis after PCI in ACS patients and PTEN alone(P<0.05).Conclusion:Serum miR-647 levels are elevated and PTEN levels are decreased in ACS patients with in-stent restenosis after PCI,both of which may be jointly involved in in-stent restenosis and can be used as a predictor of in-stent restenosis.