| Objective:In order to discover one new biomarker of acute myocardial infarction and one Traditional Chinese Medicine(TCM)syndromes objective indicator,we explore the role of plasma circular RNA-cUck2 in the diagnosis of acute myocardial infarction and TCM syndrome differentiation by detecting its expression level in healthy individuals,patients with unstable angina,and acute myocardial infarction.Methods:41 healthy volunteers in Healthy Control(HC)group,41 patients with unstable angina in Unstable Angina(UA)group and 45 patients with acute myocardial infarction in Acute Myocardial Infarction(AMI)group according to the order of visits all were enrolled from May 2017 to February 2018 in Beijing Haidian Hospital,Haidian Section of Peking University Third Hospital.When the three groups were included,basic information,clinical data,and blood samples were collected.In addition,acute myocardial infarction patients were drew elbow venous blood specimen in continuous five time points,including the moment of admission,the 1st day,the 2nd day,the 3rd day,the 7th day at the time 6:00 a.m.±30min after admission.At the same time,clinical data and differentiate TCM syndromes were collected.Circular RNA-cUck2 was detected by using fluorescence quantitative Polymerase Chain Reaction(qPCR)and Troponin Ⅰ(TnⅠ),myoglobin(Myo),MB isoenzyme of creatine kinase(CKMB)in whole blood samples were measured by immunoassay.Results:45 patients in the AMI group was classified according to TCM syndromes at the time point of admission.There were 19 patients with qi deficiency blood stasis syndrome,accounting for 42.22%;16 patients with phlegm and blood stasis syndrome,accounting for 35.56%;4 patients with Hanning heart syndrome,accounting for 9%;6 patients with positive yang deficiency syndrome,accounting for 13.33%.Statistical analysis showed that:(1)The level of cUck2 in the AMI group(1.80±1.40),the moment of admission 3.11 hours on average,was higher than that in HC group(1.23±1.3 0)、U A group(1.3 0±1.3 8).Both the HC group and the UA group was significantly different from the AMI group(P=0.007,P=0.015).There was no significant difference in cUck2 levels between HC and UA groups(P=0.982).Receiver operating characteristic curve(ROC curve)analysis showed that area under the curve was 0.847,the corresponding cUck2 cutoff point was 1.38.Its sensitivity was 81%and specificity was 84.2%,which indicated that cUck2 had a certain diagnostic significance in AMI disease.(2)Dynamically,cUck2 and TnI showed consistent trends at the time of admission,the 1st day,the 2nd day,the 3rd day,the 7th day after admission.The TnI level peaked in18h,recovered to normal in the 7th day approximately.The cUck2 level reached a peak around 42h,and in the 7th day was similar to normal.(3)Among the TnI,CKMB,and Myo negative patients within 1 hour,the cUck2 level above the cutoff point accounted for 57.14%,60%,55.56%,respectively.(4)Among the four TCM syndromes groups,the proportion of qi deficiency blood stasis syndrome and phlegm and blood stasis syndrome were the highest.There was a statistically significant difference between the two groups(P=0.009).Conclusion:(1)The plasma circular RNA-cUck2 in patients with acute myocardial infarction was significantly higher than that in patients with unstable angina.It had a differential diagnostic value and might serve as a diagnostic biomarker for acute myocardial infarction.(2)The plasma circular RNA-cUck2 had a consistent trend with TnI at different time points,reached a peak around 42h,and returned to near normal in the 7th day.(3)The plasma circular RNA-cUck2 was elevated within one hour of the onset of acute myocardial infarction,might have an early diagnostic value.(4)The expression level of cUck2 in patients with qi deficiency blood stasis during acute myocardial infarction was significantly higher than that of other syndromes,which might serve as an objective indicator of TCM syndromes. |
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