老年急性心肌梗死患者PCI术后血清CircHipk3、miR-29b-3p表达水平及其对MACE的预测价值

Expression levels of serum CircHipk3 and miR-29b-3p in elderly patients with acute myocardial infarction after PCI and their predictive value for MACE prognosis

目的探讨老年急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后血清环状RNA同源域相互作用蛋白激酶3(CircHipk3)、微小RNA(miR)-29b-3p表达水平及其对主要不良心血管事件(MACE)的预测价值。方法选取2019年8月至2021年8月在开滦总医院赵各庄医院进行PCI术的225例AMI患者作为研究对象,对患者随访,根据是否发生MACE分为MACE组和非MACE组。采用实时荧光定量聚合酶链反应检测PCI术后血清CircHipk3、miR-29b-3p表达水平。绘制受试者工作特征(ROC)曲线分析血清CircHipk3、miR-29b-3p对AMI患者PCI术后发生MACE的预测价值。采用Pearson相关分析发生MACE的AMI患者血清CircHipk3表达水平与miR-29b-3p表达水平的相关性。采用多因素Logistic回归分析AMI患者PCI术后发生MACE的危险因素。采用Starbase在线软件预测CircHipk3与miR-29b-3p的结合位点。结果225例AMI患者共有58例患者发生MACE,发生率为25.78%。MACE组冠状动脉多支病变患者比例高于非MACE组,肌钙蛋白(cTn)T、CircHipk3表达水平高于非MACE组,左心室射血分数(LVEF)、miR-29b-3p表达水平低于非MACE组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,发生MACE的AMI患者血清CircHipk3表达水平与miR-29b-3p表达水平呈负相关(r=-0.597,P<0.05)。血清CircHipk3联合miR-29b-3p预测AMI患者PCI术后发生MACE的曲线下面积(AUC)显著大于CircHipk3、miR-29b-3p单独预测的AUC(Z_(联合-CircHipk3)=2.276,P=0.021;Z_(联合-miR-29b-3p)=2.113,P=0.039)。多因素Logistic回归分析结果显示,冠状动脉多支病变、CircHipk3>1.32、miR-29b-3p≤0.84是AMI患者PCI术后发生MACE的危险因素(P<0.05)。Starbase软件预测结果显示,CircHipk3的3′-UTR有miR-29b-3p的结合位点。结论AMI患者血清CircHipk3表达水平升高,miR-29b-3p表达水平降低,二者联合检测对AMI患者PCI术后发生MACE有一定预测价值。

Objective To investigate the expression levels of serum circular RNA homologous domain interaction protein kinase 3(CircHipk3)and microRNA(miR)-29B-3p after percutaneous coronary intervention(PCI)in elderly patients with acute myocardial infarction(AMI)and their predictive value for major adverse cardiovascular events(MACE)prognosis.Methods A total of 225 patients with AMI who underwent PCI in Zhaogezhuang Hospital of Kailuan General Hospital from August 2019 to August 2021 were selected as the study objects.The patients were followed up and divided into MACE group and non-MACE group according to whether they had MACE.Real-time fluorescence quantitative polymerase chain reaction was used to detect the expression levels of CircHipk3 and miR-29b-3p after PCI.Receiver operating characteristic(ROC)curve was plotted to analyze the predictive value of serum CircHipk3 and miR-29b-3p on the occurrence of MACE after PCI in AMI patients.The correlation between the expression level of serum CircHipk3 and miR-29b-3p of AMI patients with MACE was analyzed by Pearson correlation analysis.Multivariate Logistic regression was used to analyze the risk factors of MACE in AMI patients after PCI.Starbase online software was used to predict the binding sites of CircHipk3 and miR-29b-3p.Results Among 225 AMI patients,58 patients had MACE,and the incidence was 25.78%.The proportion of patients with multi-vessel coronary artery disease in MACE group was higher than that in non-MACE group,the expression levels of troponin(cTn)T and CircHipk3 in MACE group were higher than those in non-MACE group,and the expression levels of left ventricular ejection fraction(LVEF)and miR-29b-3p in MACE group were lower than those in non-MACE group,with statistical significance(P<0.05).The results of Pearson correlation analysis showed that the expression level of serum CircHipk3 of AMI patients with MACE was negatively correlated with the expression level of serum miR-29b-3p(r=-0.597,P<0.05).The area under the curve(AUC)predicted by serum CircHipk3 combined with miR-29b-3p for the occurrence of MACE in AMI patients after PCI was significantly larger than that predicted by CircHipk3 and miR-29b-3p alone(Z _(combined with-CircHipk3)=2.276,P=0.021;Z _(combined with-miR-29b-3p)=2.113,P=0.039).Multivariate Logistic regression analysis showed that multi-vessel coronary artery disease,CircHipk3>1.32,miR-29b-3p≤0.84 were the risk factors for MACE in AMI patients after PCI(P<0.05).Starbase s oftware predicted that CircHipk3 had a miR-29b-3p binding site in its 3′-UTR.Conclusion The expression level of serum CircHipk3 of AMI patients is increased,and the expression level of miR-29b-3p is decreased.The combination of the two can predict the occurrence of MACE in AMI patients after PCI.