Clinical Study Of CircSCMH1/hsa-miR-874 Ratio Loaded With Exosomes In Peripheral Serum To Predict Carotid And Coronary Plaque Stability

Background:The most significant threat to the health of our population is ischemic cardio-cerebrovascular diseases,which are a type of atherosclerotic cardiovascular disease.These diseases are primarily caused by the instability or rupture of atherosclerotic plaque.Carotid atherosclerosis serves as a reflection of systemic atherosclerosis and is strongly linked to high-risk cardiovascular diseases and other vascular-related illnesses.Exosomes carry non-coding ribonucleic acids(ncRNAs)between cells and tissues to achieve biological information transmission,and are widely used in the study of various cardiovascular diseases.Earlier research has revealed a notable decrease in the expression of circSCMHl in ischemic stroke models.Although some studies suggest that miR-874 is lowly expressed in patients with acute myocardial infarction(AMI),mainstream evidence shows that miR-874 can promote apoptosis and inhibit cell proliferation.The aim of this study was to detect the ratio of circSCMH1 to hsa-miR-874 loaded by exosomes from peripheral serum and explore its relationship with atherosclerotic plaque stability.Objective:By collecting information from different groups of hospitalized patients and grouping them,we detect and calculate the ratio of peripheral serum exosomes circSCMH1 and hsa-miR-874 in different study groups,and perform statistical analysis to explore the relationship between this ratio and the incidence of ACS,AMI,and carotid plaque stability.Methods:Select 300 patients diagnosed with ACS or stable angina pectoris who were treated at the Second Hospital of Shandong University from January to December 2022,and divide them into the stable angina pectoris group and the ACS group.Collect 101 hospitalized patients who deny a history of coronary artery and carotid artery diseases such as coronary heart disease and angina pectoris as the control group due to other diseases.Further select a group of patients who received carotid artery ultrasound examination from the above 701 patients.According to the results of carotid artery ultrasound,divide them into the low-risk plaque group,the medium and high-risk plaque group,and the control group who did not have carotid artery plaque detected by ultrasound.Collect their peripheral blood and extract serum,extracellular vesicles,identify ncRNAs,and use standard solutions of circSCMH1 and hsa-miR-874 to prepare standard curves with different concentrations of standard solutions.Quantify the ct values of different concentration standard solutions using real-time fluorescent quantitative PCR(qPCR)to prepare standard curves.Calculate the content of circSCMHl and hsa-miR-874 in peripheral blood serum extracellular vesicle load based on the standard curve and calculate the ratio between the two.Combine their clinical medical records for statistical analysis.Results:1.The ratio of circSCMHl to hsa-miR-874 content was taken as the logarithm of 10[lg(circSCMH1/hsa-miR-874)]and compared.(1)Lg(circSCMH1/hsa-miR-874)was decreased in the ACS group and the stable coronary heart disease group compared with the control group;and lg(circSCMH1/hsa-miR-874)was decreased in the ACS group compared with the stable coronary heart disease group.The differences were statistically significant.(2)Compared with the control group,lg(circSCMH1/hsa-miR-874)was decreased in the intermediate-high risk plaque group.No meaningful distinction was observed between the control group and the group with low-risk plaque.The comparison between the group with intermediate-high risk plaque and the group with low-risk plaque showed a significant decrease in Lg(circSCMH1/hsa-miR-874),which was statistically significant.2.Logistic regression analysis was performed with lg(circSCMH1/hsa-miR-874)as one of the independent variable,and it was found that:(1)When ACS was employed as the dependent variable to determine its presence or absence:OR=0.140,P<0.05;(2)When AMI was employed as the dependent variable to determine its presence or absence:OR=0.729,P<0.05.(3)When the occurrence of moderate to high risk plaques in carotid artery was used as the dependent variable,OR=0.577,P<0.05.The circSCMHl/hsa-miR-874 ratio was an independent risk factor for the development of ACS,AMI and the detection of carotid medium and high risk plaques.Patients were at increased risk of ACS.AMI.and medium-high risk plaques in the carotid arteries as lg(circSCMHl/hsa-miR-874)decreasing3.ROC curve analysis of the diagnostic value of lg(circSCMH1/hsa-miR-874)for patients with ACS,AMI or unstable carotid plaque:The AUC values of ROC curves for predicting ACS,AMI,and high-risk carotid plaques were 0.893(95%CI was 0.862-0.923).0.862(95%CI was 0.822-0.902),and 0.815(95%CI was 0.753-0.877),respectively.The sensitivity and specificity of the models ranged from 72.5%to 89.0%and from 81.4%to 88.2%,respectively.The cut-off values were between 1.38 and 3.41.These AUC values were higher than those of previously used predictive ratios such as neutrophil/lymphocyte ratio(NLR),monocyte/lymphocyte ratio(MLR),and peripheral blood platelet/lymphocyte ratio(PLR).Conclusions:The ratio of peripheral blood exosomes containing circSCMH1 and hsa-miR-874 exhibited a correlation with the stability of coronary and carotid plaques,and was identified as an independent risk factor in the progression of ACS,AMI,and intermediate-to-high risk plaque.After taking the logarithm of the ratio of 10[lg(circSCMH1/hsa-miR-874)],it had a good predictive effect on the occurrence of ACS,AMI,and carotid intermediate-to-high risk plaques.And the prediction effect is better than previous prediction ratios such as NLR,MLR,PLR,blood uric acid/neutrophil ratio,monocyte/high-density lipoprotein cholesterol ester ratio,and triglyceride/high-density lipoprotein cholesterol ratio.