The Plasma Levels Of MiR-146a And MiR-34a In Patients With STEMI Before And After Revascularization

[Objective]1)To investigate the dynamic changes of plasma microRNA-146a(miR-146a)and microRNA-34a(miR-34a)expression in patients with ST-segment Elevation Myocardial Infarction(STEMI)before and after 24 hours,48 hours and 72 hours after revascularization.2)To explore the correlation between the plasma levels of miR-146a and miR-34a and myocardial injury,left ventricular function,SYNTAX score and D-to-B(door-to-balloon)time at different time points.[Methods]1)A total of 41 hospitalized patients in Department of Cardiology,First Affiliated Hospital of Kunming Medical University from September 2019 to January 2020 were selected.Among them,21 patients with STEMI underwent PCI as the observation group and 20 patients with normal coronary angiography as control group.2)Venous blood samples from patients with STEMI before and after 24,48,72 hours and normal coronary angiography were collected,and plasma miRNA was extracted after centrifugation of blood samples.The plasma levels of miR-146a and miR-34a were measured by real-time quantitative technique in STEMI patients at different time points and in normal coronary artery.3)During hospitalization,blood routine test,blood biochemistry,myocardial necrosis markers,echocardiographyandcoronary angiography were performed to measure the left ventricular ejection fraction(LVEF)and left ventricular end systolic volume end-systolic volume(LVESV)and Left ventricular end diastolic volume(LVEDV)and so on.3)To explore the correlation between plasma miR-146a and miR-34a at different time points and myocardial injury markers and left ventricular function indexes.[Results]1.Comparison of plasma miR-146a and miR-34a levels between normal group and STEMI group1)The plasmalevel of miR-146a in STEMI patients was significantly higher than that in the normal control group(p<0.001).2)Compared with the normal control group,the plasma level of miR-34a in STEMI patients was also increased,the difference was statistically significant(p<0.001).2.The plasma levels of miR-146a and miR-34a at different time points before and after revascularization in STEMI patients1)The plasma level of miR-146a in patients with STEMI decreased 24 hours(p<0.05)and 48 hours(p<0.001)after operation,and the difference was statisticallysignificant.However,there was no significant difference in plasma miR-146a expression at 72 hours after operation.2)There was no significant difference in the plasma level of miR-34aat 24 hours after STEMI in patients with STEMI compared with preoperative STEMI.The plasmalevel of plasma miR-34a in patients with STEMI decreased 48 hours after surgery(p<0.001).3.Correlation between the plasma levels of miR-146a and miR-34a and myocardial necrosis markers and left ventricular function in patients with STEMI in the progress of revascularization1)There was a positive correlation between the plasma level ofiniR-146a and LVEF in STEMI patients 72 hours after operation.The difference was statistically significant(p<0.05).Besides,there was no significant correlation between the plasma level of miR-146a and cTnI,CK-MB,MYO,LVEF,LVEDV and LVESV at other time points.2)There was a negative correlation between the plasma level of plasma miR-34a and CK-MB before revascularization in STEMI patients.The difference was statistically significant(p<0.05).Besides,there was no significant correlation between plasma miR-34a level and cTnI,CK-MB,MYO,LVEF,LVEDV and LVESV at other time points4.Correlation between the plasma levels of miR-146a and miR-34a and SYNTAX score and D-to-B time in patients with STEMI in the progress of revascularization1)There was a negative correlation between the plasma level of miR-146a and D-to-B time in STEMI patients 72 hours after operation.The difference was statistically significant(p<0.05).Besides,there was no significant correlation between the plasma level of miR-146a and SYNTAX score and D-to-B time at other time points.2)There was apositive correlation between the plasma level of miR-34a and D-to-B time in STEMI patients 24 hours after operation.The difference was statistically significant(p<0.05).Besides,there was no significant correlation between the plasma level of miR-146a and SYNTAX score and D-to-B time at other time points5.ROC curve analysis of plasma miR-146a and miR-34a in diagnosis of STEMI1)ROC analysis of plasma miR-146a showed that AUC=0.82(95%confidence interval,0.688-0.950,P<0.001)had diagnostic value.2)ROC analysis of plasma miR-34a showed that AUC=0.83(95%confidence interval,0.696-0.957,P<0.001)had diagnostic value.3)The plasma level of miR-146a and miR-34a combined with ROC analysis showed that AUC=0.79(95%confidence interval,0.792-0.994,P<0.0001)had diagnostic value.[Conclusions]1.The plasma levels of miR-146a and miR-34a in patients with STEMI decreased in 24～48 hours after revascularization,and the plasma level of plasma miR-34a increased gradually in 48～72 hours after revascularization.2.The plasma level of plasma miR-146a in STEMI patients was positively correlated with LVEF in 72 hours after revascularization,and negatively correlated with D-to-B time,the plasma level of mir-146a after revascularization may indicate the change of ventricular systolic function.3.The plasma level of miR-34a in 24h after revascularization was positively correlatedwith D-to-B time,D-to-B time may affect the expression level of mir-34a after revascularization.4.The plasma levels of miR-146a and miR-34a in STEMI patients were higher than those in normal coronary angiography group.Plasma miR-146a and miR-34a had potential to be the diagnosis tool for STEMI.