| Objective: To analyze the expression changes of Mir-199a-5p and Sirt1 in blood of patients with acute myocardial infarction,and to analyze the prognostic significance of Mir-199a-5p and Sirt1 in predicting poor prognosis of STEMI in combination with the clinical characteristics of ST-segment elevation myocardial infarction(STEMI).Methods: Sixty patients with ST-Segment Elevation myocardial infarction(STEMI)who were admitted to the Department of Cardiology of our hospital from December 2020 to June 2021 were selected.All patients were treated with PCI.Strict admission criteria and exclusion criteria were established for st-segment elevation myocardial infarction patients enrolled in the study.Another 60 healthy subjects in our hospital during the same period were selected as the control group.STEMI patients were divided into two groups according to the situation of recrudescence after PCI: the group with and without recrudescence after PCI.STEMI patients were divided into low Gensini score group(0-40)and high Gensini score group(>40)according to Coronary angiography(CAG)and other relevant examinations.STEMI patients were divided into MACE group and non-MACE group according to whether adverse cardiovascular events(MACE)(including non-fatal myocardial infarction,revascularization,non-fatal stroke,cardiogenic death,recurrent angina pectoris etc.)occurred in follow-up of STEMI patients within 6 months after PCI.Routine basic data and blood biochemical indices of STEMI patients were included.Blood samples of all the enrolled population were collected,and the mRNA expression differences of mir-199a-5p and Sirt1 in peripheral blood samples were detected by QRTPCR,and clinical data were collected and collated.The correlation between the expression of blood mir-199a-5p and srit1 in patients with ST elevation myocardial infarction was analyzed by linear regression,and the patients with ST elevation myocardial infarction were analyzed by logistic regression Independent risk factors for poor prognosis;Pearson method was used to analyze the correlation between the expression levels of serum mir-199a-5p and SIRT1 and the prognostic factors of acute myocardial infarction(coronary Gensini score,blood CTnl level,blood CK-MB and PCI reflow,etc.);ROC curve was used to analyze the accuracy and specificity of blood mir-199a-5p and SIRT1 in analyzing the poor prognosis of ST segment elevation myocardial infarction.Results:1.The mRNA expression level of mir-199a-5p in peripheral blood of STEMI group was significantly higher than that of the normal population,and the mRNA expression level of Sirt1 was significantly lower than that of the normal population(P < 0.05).2.The mRNA expressions of mir-199a-5p and SIRT1 in blood of STEMI patients were negatively correlated,with a correlation coefficient r of-0.519,P < 0.05.3.The mRNA expression level of sirt1 in peripheral blood of patients with relapse after PCI was significantly higher than that of patients without relapse after PCI;The mRNA expression level of Mir-199a-5p in peripheral blood of patients without relapse after PCI was significantly higher than that of patients with relapse after PCI(P < 0.05).4.The mRNA expression of mir-199a-5p in peripheral blood of patients with high Gensini score group was significantly higher than that of patients with low Gensini score group,and the mRNA expression of sirt1 in peripheral blood of patients with low Gensini score group was significantly higher than that of patients with high Gensini score group(P< 0.05).5.The history of hyperlipidemia,hypertension,systolic blood pressure,triglyceride(TG),low density lipoprotein cholesterol(LDL-C),cardiac troponin(cTnI),creatine kinase isoenzyme(CK-MB),mir-199a-5p and Gensini scores in MACE group were significantly higher than those in non-MACE group(P < 0.05);The expression level of sirt1 and the recurrence rate after PCI in MACE group were significantly lower than those in nonMACE group(P < 0.05).There were no significant differences in gender,age,smoking history,diabetes,diastolic blood pressure,cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and fasting blood glucose(FPG)between 2 groups(P > 0.05).6.Cardiac troponin(cTnI,OR=1.236,95%CI=1.125-1.692,P < 0.05),creatine kinase isoenzyme(CK-MB,OR=1.191,95%CI=1.053-1.548,P < 0.05),Mir-199a-5p(OR=1.208,95%CI=1.069-1.513,P < 0.05),SIRT1(OR=0.854,95%CI=0.782-0.964,P < 0.05),Gensini score(OR=1.402,95%CI=1.193-1.629,P < 0.05),recurrence after PCI(OR=0.762,95%,CI=0.617-0.896,P < 0.05)was an independent prognostic factor for STEMI patients.7.Mir-199a-5p level in peripheral blood of STEMI patients was positively correlated with creatine kinase isozyme(r=0.639,P < 0.05),cardiac tropicin(R =0.726,P < 0.05)and Gensini score(r=0.807,P < 0.05).It was negatively correlated with recrudescence after PCI(r=-0.671,P < 0.05).Sirt1 levels in peripheral blood of STEMI patients were negatively correlated with creatine kinase isozyme(R =-0.715,P < 0.05),cardiac troponin(r=-0.692,P < 0.05)and Gensini score(r=-0.823,P < 0.05).It was positively correlated with recrudescence after PCI(r=0.654,P < 0.05).8.The area under the mir-199a-5p curve(AUC)was 0.872(95%CI=0.658-0.967,P <0.05),and the area under the Sirt1 curve(AUC)was 0.725(95%CI=0.571-0.819,P < 0.05).Conclusion:1.Abnormal high expression of mir-199a-5p and abnormal low expression of SIRT1 were found in peripheral blood of patients with ST-segment elevation myocardial infarction,and the mRNA expression of mir-199a-5p and SIRT1 was negatively correlated.Therefore,Mir-199a-5p and SIRT1 could be combined to study the clinical characteristics of STEMI patients.2.The expression of mir-199a-5p increased and SIRT1 decreased in STEMI patients with adverse cardiovascular events,and the levels of mir-199a-5p and SIRT1 in blood can be used as independent factors for the prognosis of STEMI patients.3.The levels of mir-199a-5p and SIRT1 in blood of STEMI patients were correlated with other prognostic factors.Mir-199a-5p was positively correlated with creatine kinase isoenzyme,cardiac troponin and Gensini score,and negatively correlated with recrudescence after PCI.Sirt1 was negatively correlated with creatine kinase isoenzyme,cardiac troponin and Gensini score,and positively correlated with recrudescence after PCI.So the levels of mir-199a-5p and SIRT1 in blood of STEMI patients were correlated with other prognostic factors.4.Mir-199a-5p and SIRT1 levels in peripheral blood have the advantage of specificity and accuracy in predicting poor prognosis in STEMI patients,so they can be used as one of the potential prognostic indicators. |
