MicroRNA-492、红细胞微粒水平预测STEMI患者PCI术后预后的价值

Evaluation of miR-492 and erythrocyte microparticle levels in predicting prognosis of STEMI patients after PCI

摘要:

目的 探究microRNA-192（miR-492）和红细胞微粒（RMPs）水平对ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入术（PCI）术后预后的预测价值。方法 回顾性分析2020年5月—2022年12月淮安市第二人民医院收治的87例行PCI的STEMI患者的临床资料。收集患者术前临床相关资料、miR-492、RMPs水平及实验室指标等。术后随访6个月，根据主要不良心血管事件（MACE）发生情况，分为预后良好组（无MACE）和预后不良组（发生MACE）。比较两组患者miR-492、RMPs水平及临床相关资料等。分析影响预后的因素，并分析miR-492、RMPs预测预后的价值。结果 预后不良组患者miR-492和RMPs水平均高于预后良好组（P <0.05）。预后不良组年龄、SYNTAX积分、发病至介入治疗时间、Killip Ⅳ级占比、冠脉血栓高负荷和术后抗血小板药物使用时长均高于预后良好组（P <0.05）。预后不良组心肌肌钙蛋白Ⅰ、脑钠肽、肌酸激酶同工酶水平均高于预后良好组（P <0.05）。多因素一般Logistic回归分析结果显示：miR-492相对表达量高、RMPs高水平、发病至介入治疗时间长均为患者预后不良的危险因素（P <0.05）。ROC曲线结果显示，miR-492、RMPs及联合预测STEMI患者预后的曲线下面积分别为0.779、0.790、0.936，敏感性分别为71.4%、76.2%、90.5%，特异性分别为74.2%、75.8%、84.8%。结论 miR-492、RMPs是STEMI患者PCI术后预后不良的独立危险因素，二者联合检测可有效预测患者预后。

Abstract:

Objective To investigate the prognostic value of microRNA-492 (miR-492) and red blood cell microparticles (RMPs) levels in patients with ST-elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).Method A total of 87 patients with STEMI who underwent PCI from May 2020 to December 2022 were retrospectively included. Preoperative clinical data and levels of miR-492, RMPs and other laboratory indicators were collected. The patients were followed up for 6 months after surgery. According to the occurrence of major adverse cardiovascular events (MACE), they were divided into the good prognosis group (without MACE) and the poor prognosis group (with MACE). The levels of miR-492 and RMPs as well as relevant clinical characteristics were compared between the two groups. The prognostic factors were analyzed, and the prognostic value of miR-492 and RMPs was determined.Results The levels of miR-492 and RMPs in patients with poor prognosis were higher than those in patients with good prognosis (P < 0.05). Patients with poor prognosis were older and had higher SYNTAX scores, longer time from onset to interventional treatment, a greater proportion of Killip class IV, higher coronary thrombus burden, and longer duration of postoperative antiplatelet therapy compared with those with good prognosis (P < 0.05). Levels of cTnI, BNP, and CK-MB were also higher in the poor prognosis group than in the good prognosis group (P < 0.05). Multivariable logistic regression analysis showed that high levels of miR-492 and RMPs, and long time from onset to interventional treatment were risk factors for poor prognosis (P < 0.05). The receiver operating characteristic (ROC) curve analysis showed that the areas under the curves (AUCs) of miR-492, RMPs, and their combination for predicting the prognosis of STEMI patients were 0.779, 0.790, and 0.936, respectively, with sensitivities of 71.4%, 76.2%, and 90.5%, and specificities of 74.2%, 75.8%, and 84.8%, respectively.Conclusions High levels of miR-492 and RMPs are independent risk factors for the prognosis of STEMI patients after PCI, and the combined detection of miR-492 and RMPs can effectively predict the prognosis of patients.