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Evaluating Diagnostic and Prognostic Value of Plasma miRNA133a in Acute Chest Pain Patients Undergoing Coronary Angiography

机译:评价血浆miRNA133a在急性冠心病患者胸痛中的诊断和预后价值

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摘要

Circulating microRNA has recently emerged as a promising biomarker for cardiovascular disease. This study sought to evaluate the diagnostic and prognostic value of circulating miR-133a as a marker of acute myocardial infarction in acute chest pain patients undergoing coronary angiography.Plasma was collected from 312 patients with chest pain on admission in the emergency department and 67 healthy controls. MiR-133a was detected using real-time quantitative PCR and enhanced accu-TnI, creatinine kinase-MB mass, and myoglobin were measured by immunoassay. End-point events (serious adverse cardiovascular events which require hospitalization or cardiovascular death) were examined in the AMI (acute myocardical infarction) group within 1, 6, 12, and 24 months.The miR-133a level was higher in AMI patients than in non-AMI patients (P < 0.001). In the ROC analysis, the sensitivity of miR-133a in diagnosis of AMI is 0.61 and the specificity is 0.68. In the prognostic analysis, only 1 endpoint event was observed in the non-AMI group; the amount of cases with end-point events in the AMI group at 1,6,12, and 24 months were 8, 19, 28, and 35, respectively. The cutoff value of miR-133a was determined using the median value of the AMI group and separated the patients into a positive group and a negative group. The Kaplan–Meier survival curve showed no significant difference in survival was detected in AMI patients between the miR-133a positive group and negative group after follow-up (12-month: x2 = 1.353, P = 0.245; 24-month: x2 = 3.722, P = 0.054). After adjusting for age, gender, Killip classes, prior myocardiac infarction history, myoglobin, LVEF (left ventricular ejection fraction), diabetes, hypertension, smoking and systolic blood pressure, miR133a had a significant association with the risk of events at 12 months (HR = 2.869, P = 0.024) and 24 months (HR = 3.936, P = 0.001).In patients undergoing coronary angiography, circulating miR-133a is upregulated in AMI patients, but it does not provide enough accuracy for clinical AMI diagnosis because it also rises in unstable angina patients. Its prognostic value in AMI is uncertain mainly for the number of cases with end-point event was small and may be further validated in a larger, better designed study.
机译:循环microRNA最近已成为心血管疾病的有前途的生物标志物。本研究旨在评估循环miR-​​133a作为急性冠心病患者的急性心肌梗死的标志物的诊断和预后价值。从312名急诊科住院的胸痛患者和67名健康对照中收集血浆。使用实时定量PCR检测了MiR-133a,并通过免疫测定法测量了增强的Accu-TnI,肌酐激酶-MB质量和肌红蛋白。在AMI(急性心肌梗塞)组在1,6,12,24个月内检查了终点事件(需要住院或心血管死亡的严重不良心血管事件).AMI患者的miR-133a水平高于AMI患者。非AMI患者(P <0.001)。在ROC分析中,miR-133a对AMI诊断的敏感性为0.61,特异性为0.68。在预后分析中,非AMI组仅观察到1个终点事件。 AMI组在1,6,12和24个月发生终点事件的病例数分别为8、19、28和35。使用AMI组的中值确定miR-133a的临界值,并将患者分为阳性组和阴性组。 Kaplan–Meier生存曲线显示,随访后,miR-133a阳性组和阴性组在AMI患者中检测到的生存率无显着差异(12个月:x2 = 1.353,P = 0.245; 24个月:x2 == 3.722,P = 0.054)。在调整了年龄,性别,Killip类别,先前的心肌梗塞病史,肌红蛋白,LVEF(左心室射血分数),糖尿病,高血压,吸烟和收缩压后,miR133a与发生12个月事件的风险显着相关(HR) = 2.869,P = 0.024)和24个月(HR = 3.936,P = 0.001)。在进行冠状动脉造影的患者中,循环miR-​​133a在AMI患者中被上调,但由于其同时也无法为临床AMI诊断提供足够的准确性在不稳定型心绞痛患者中升高。其在AMI中的预后价值尚不确定,主要是因为发生终点事件的病例数量很少,并且可能会在规模更大,设计更好的研究中得到进一步验证。

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