| BackgroundAt present,the number of cardiovascular disease patients in China is as high as330 million,and the case fatality rate accounts for more than 40% of the disease death rat,and it continues to rise.Acute coronary syndrome(ACS)is a common complication and cause of death of cardiovascular disease.Its onset is acute,its condition is critical,and its mortality is high.Early identification and active intervention are essential to save dying myocardium,delay disease progression and improve long-term prognosis.In recent years,studies have found that circular RNA(circ RNA)plays an important role in the prevention,diagnosis,treatment and improvement of prognosis of cardiovascular diseases.Previous studies have shown that the circ RNAs composed of circ PDS5 B and circ CDC14 A can be used as biomarker for the diagnosis of acute ischemic stroke.The expression level was positively correlated with the infarct size of patients.However,it is unclear whether it is involved in the occurrence and development of ACS and its value in the diagnosis and assessment of coronary artery severity of ACS.ObjectivesThis experiment is intended to explore the difference in the expression of circ PDS5 B and circ CDC14 A in circulating plasma of different groups of patients,and assess whether it can become a biomarker for auxiliary diagnosis of ACS;Further explore the correlation between its expression level and the severity of coronary artery disease,and determine whether it can be used as an indicator to predict the severity of coronary artery disease;Finally,to explore the possible mechanism of its participation in ACS.MethodsThis study randomly selected 302 patients in the Department of Cardiovascular Medicine of the Second Norman Bethune Hospital of Jilin University from March to November 2022 as the study subjects.According to the inclusion criteria and exclusion criteria,72 patients with ACS were finally selected(34 patients in AMI group,38 patients in UA group)and 30 patients in control group.Firstly,the general clinical data of the enrolled patients were collected in this experiment,then all patients were divided into three subgroups according to the results of the Gensini score.Multivariate logistic regression analysis was used to explore the factors that can predict the occurrence of ACS and the severity of coronary artery disease;Secondly,5 ml of peripheral venous blood was collected from the patients in the group,and plasma was collected by centrifugation.The total RNA in plasma was extracted by plasma RNA extraction kit.The expression levels of circ PDS5 B and circ CDC14 A were detected by real-time polymerase chain reaction;Thirdly,Spearman correlation analysis was used to explore the correlation between the expression levels of circ PDS5 B and circ CDC14 A in plasma and statistically significant predictive factors,as well as the correlation with the Gensini score.Finally,the receiver operating characteristic curve was produced to evaluate the predictive value of the two to ACS.Results1.The leukocyte count and neutrophil percentage are related to the occurrence of ACS and the severity of coronary artery disease.2.The expression levels of plasma circ PDS5 B and circ CDC14 A in ACS group were significantly higher than that in Control group(p<0.05);Further subgroup analysis showed that the expression levels of plasma circ PDS5 B and circ CDC14 A in AMI group were higher than those in UA group(p<0.05);The expression level of plasma circ CDC14 A in UA group was higher than that in control group(p<0.05),while the expression level of circ PDS5 B was not significantly different from that in control group(p>0.05).3.The expression levels of circ PDS5 B and circ CDC14 A in plasma of patients in the third quartile of Gensini score group were significantly higher than that in the first and second quartiles,with significant statistical difference(p<0.05);The expression level of plasma circ CDC14 A in the second quantile group was higher than that in the first quantile group,and the difference was statistically significant(p<0.05),while the expression level of circ PDS5 B was not statistically significant between the first and second quartiles(p>0.05).4.The expression levels of plasma circ PDS5 B and circ CDC14 A were positively correlated with the white blood cell count,and the correlation was statistically significant(r=0.31,p<0.05;r=0.47,p<0.05).The expression level of plasma circ PDS5 B was positively correlated with the percentage of neutrophils,but the correlation was not statistically significant(r=0.17,p>0.05),the expression level of plasma circ CDC14 A was positively correlated with the percentage of neutrophils,and the correlation was statistically significant(r=0.45,p<0.05).5.The expression levels of plasma circ PDS5 B and circ CDC14 A were positively correlated with the severity of coronary artery disease(r=0.47,p<0.05;r=0.66,p<0.05).6.Prediction level of plasma circ PDS5 B and circ CDC14 A on ACS: The area under the ROC curve of plasma circ PDS5 B to predict ACS was 0.708(95% CI: 0.601-0.815;p<0.01),and the optimal critical value was 3.02(sensitivity: 36.1%,specificity:96.7%);The area under the ROC curve of plasma circ CDC14 A to predict ACS was0.896(95% CI: 0.837-0.955;p<0.01),and the optimal critical value was 2.16(sensitivity: 76.4%,specificity: 93.3%);The area under the ROC curve of plasma circ PDS5 B combined with circ CDC14 A to predict ACS was 0.95(95% CI: 0.912-0.989;p<0.01),sensitivity: 83.3%,specificity: 96.7%.Conclusions1.The expression levels of plasma circ PDS5 B and circ CDC14 A are positively correlated with the white blood cell count.2.The expression levels of plasma circ PDS5 B and circ CDC14 A are positively correlated with the severity of coronary artery disease,which can be used as indicators to predict the severity of coronary artery disease.3.The combination of plasma circ PDS5 B and circ CDC14 A has the value of assisting in the diagnosis of ACS,and may be a potential biomarker for assisting in the diagnosis of ACS. |
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