血清lncRNA LOXL1-AS1、miR-3614-5p水平对急性心肌梗死后心律失常的预测价值

The predictive value of serum lncRNA LOXL1-AS1 and miR-3614-5p levels for arrhythmia after acute myocardial infarction

目的探讨长链非编码RNA(lncRNA)赖氨酰氧化酶样1-反义RNA1(LOXL1-AS1)、微小RNA(miR)-3614-5p在急性心肌梗死患者血清中的表达水平,以及对心律失常的预测价值。方法选择2021年1月—2023年1月西安交通大学第一附属医院心内科住院治疗急性心肌梗死患者148例作为研究对象(急性心肌梗死组),根据患者是否发生心律失常,分为非心律失常亚组(n=96)和心律失常亚组(n=52),另选取同期与急性心肌梗死患者一般资料相匹配的健康体检者148例为健康对照组。比较各组血清lncRNA LOXL1-AS1、miR-3614-5p水平;多因素Logistic回归分析急性心肌梗死后心律失常的影响因素;绘制受试者工作特征曲线(ROC)并计算曲线下面积(AUC)分析血清lncRNA LOXL1-AS1、miR-3614-5p水平对急性心肌梗死后心律失常的预测价值。结果与健康对照组比较,急性心肌梗死组lncRNA LOXL1-AS1水平升高,miR-3614-5p水平降低(t/P=16.248/<0.001、8.397/<0.001);心律失常亚组病变血管支数、lncRNA LOXL1-AS1水平高于非心律失常亚组,左心室射血分数(LVEF)、miR-3614-5p水平低于非心律失常亚组[χ^(2)(t)/P=14.315/<0.001、7.312/<0.001、3.706/<0.001、7.656/<0.001];Target Scan Human网站预测结果显示,lncRNA LOXL1-AS1与miR-3614-5p有结合位点,可能存在靶向关系;多因素Logistic回归分析结果显示,lncRNA LOXL1-AS1高、病变血管支数多是急性心肌梗死后心律失常的危险因素,miR-3614-5p、LVEF高是保护因素[OR(95%CI)=3.542(1.589~7.896)、1.527(1.081~2.156)、0.721(0.601~0.865)、0.789(0.664~0.938)];lncRNA LOXL1-AS1、miR-3614-5p及二者联合预测急性心肌梗死后心律失常的AUC为0.820、0.890、0.932,二者联合优于各自单独预测(Z/P=3.470/0.001、2.293/0.022)。结论急性心肌梗死后心律失常患者血清lncRNA LOXL1-AS1水平显著升高,miR-3614-5p水平显著降低,两者联合对急性心肌梗死后心律失常有较好的预测价值。

Objective To investigate the expression levels of long-chain non coding RNA(lncRNA)lysine oxidase like 1-antisense RNA1(LOXL1-AS1)and microRNA-3614-5p in the serum of patients with acute myocardial infarction,as well as their predictive value for arrhythmia.Methods One hundred and forty-eight patients with acute myocardial infarction who were hospitalized in the Department of Cardiology at the First Affiliated Hospital of Xi'an Jiaotong University from January 2021 to January 2023 were selected as the study subjects(acute myocardial infarction group).According to whether the patients developed arrhythmia,they were divided into non arrhythmia subgroup(n=96)and arrhythmia subgroup(n=52).In addition,148 healthy individuals who matched the general information of acute myocardial infarction patients during the same period were selected as the healthy control group.Compare the levels of serum lncRNA LOXL1-AS1 and miR-3614-5p in each group;Multivariate logistic regression analysis of the influencing factors of arrhythmia after acute myocardial infarction;Draw receiver operating characteristic(ROC)curves to analyze the predictive value of serum lncRNA LOXL1-AS1 and miR-3614-5p levels for arrhythmia after acute myocardial infarction.Results Compared with the healthy control group,the level of lncRNA LOXL1-AS1 increased and the level of miR-3614-5p decreased in the acute myocardial infarction group(t/P=16.248/<0.001,8.397/<0.001);The number of vascular branches and lncRNA LOXL1-AS1 levels in the arrhythmia subgroup were higher than those in the non arrhythmia subgroup,while LVEF and miR-3614-5p levels were lower than those in the non arrhythmia subgroup[χ^(2)(t)/P=14.315/<0.001,7.312/<0.001,3.706/<0.001,7.656/<0.001];The prediction results from Target Scan Human website show that lncRNA LOXL1-AS1 has a binding site with miR-3614-5p,indicating a possible targeting relationship;The results of multivariate logistic regression analysis showed that high lncRNA LOXL1-AS1 and multiple diseased vessel branches were risk factors for arrhythmia after acute myocardial infarction,while high miR-3614-5p and LVEF were protective factors[OR(95%CI)=3.542(1.589-7.896),1.527(1.081-2.156),0.721(0.601-0.865),0.789(0.664-0.938)];The AUC of lncRNA LOXL1-AS1,miR-3614-5p,and their combination in predicting arrhythmia after acute myocardial infarction were 0.820,0.890,and 0.932,respectively.The combination of the two was superior to their individual predictors(Z/P=3.470/0.001,2.293/0.022).Conclusion The serum lncRNA LOXL1-AS1 levels significantly increased and miR-3614-5p levels significantly decreased in patients with arrhythmia after acute myocardial infarction.The combination of the two has good predictive value for arrhythmia after acute myocardial infarction.