循环miR-361-5p、miR-223及miR-146a水平与ACS患者冠脉介入术后近期预后的关系

Relationship between the levels of circulating miR-361-5p,miR-223 and miR-146a and the short-term prognosis of patients with ACS after coronary intervention

目的 探讨循环miR-361-5p、miR-223及miR-146a水平与急性冠状动脉综合征(ACS)患者冠脉介入术后近期预后的关系。方法 选择2020年12月至2021年12月就诊于文昌市人民医院心血管内科的196例行冠脉介入术ACS患者临床资料。所有ACS患者自出院后均随访6个月,以发生主要不良心脏事件(MACE)为终点。以ACS患者随访期间是否发生MACE分为MACE组(n=29)和未发生MACE组(n=167),比较两组临床资料,将有统计学意义的因素进行Logistic回归分析,绘制ROC曲线评估miR-361-5p、miR-223及miR-146a预测ACS患者发生MACE的效能。结果 196例ACS患者共发生MACE 29例(14.79%)。单因素结果显示,两组患者年龄、Cr、Tn I、BNP、miR-361-5p、miR-223及miR-146a水平比较差异有统计学意义(P<0.05)。Logistic回归分析结果显示,miR-223是影响ACS患者冠脉介入术后近期预后的保护因素(P<0.05),miR-361-5p、miR-146a是影响ACS患者冠脉介入术后近期预后的独立危险因素(P<0.05)。循环miR-361-5p、miR-223及miR-146a预测ACS患者发生MACE的曲线下面积(AUC)分别为0.763、0.701、0.794(P<0.05)。结论 循环miR-361-5p、miR-223及miR-146a水平与ACS密切相关,在预测ACS预后方面有较高的诊断价值。

Objective To investigate the relationship between the levels of circulating miR-361-5p,miR-223 and miR-146a and the short-term prognosis of patients with acute coronary syndrome(ACS)after coronary intervention. Methods The clinical data of 196 patients with ACS who underwent coronary intervention in the Department of Cardiovascular Medicine,Wenchang People’s Hospital from December 2020to December 2021 were retrospectively reviewed. All ACS patients were followed up for 6 months after discharge,with the occurrence of(major adverse cardiac events)MACE as the endpoint. ACS patients were divided into the MACE group(n=29)and the non-MACE group(n=167)according to whether MACE occurred during the follow-up period. The clinical data of the two groups were compared,and the statistically significant factors were analyzed by Logistic regression and the ROC curve was drawn to evaluate the efficacy of miR-361-5p,miR-223 and miR-146a in predicting the occurrence of MACE in ACS patients. Results There were 29cases(14.79%) of 196 ACS patients with MACE. Univariate results showed that there were significant differences in age,Cr,Tn I,BNP,miR-361-5p,miR-223 and miR-146a levels between the two groups(P<0.05). Logistic regression analysis showed that miR-223 was a protective factor affecting the short-term prognosis of patients with ACS after coronary intervention(P<0.05),and miR-361-5p and miR-146a were independent risk factors affecting the short-term prognosis of patients with ACS after coronary intervention(P<0.05). The areas under the curve(AUC)of circulating miR-361-5p,miR-223 and miR-146a for predicting MACE in ACS patients were 0.763,0.701,and 0.794,respectively(P<0.05). Conclusion The levels of circulating miR-361-5p,miR-223 and miR-146a are closely related to ACS and have high diagnostic value in predicting the prognosis of ACS.