Relationship between miR-374a-5p and intrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction

doi:10.3760/cma.j.issn.1007-1245.2023.12.012

Abstract

Abstract:

Objective　To explore and analyze the relationship between miR-374a-5p and intrastent thrombosis within 6 months after percutaneous coronary intervention (PCI) for patients with ST-segment elevation myocardial infarction. Methods　The clinical data of 138 patients with ST-segment elevation myocardial infarction treated by PCI at Jincheng People's Hospital from April 2020 to March 2022 were retrospectively analyzed. According to whether intrastent thrombosis occurred 6 months after the surgery, the patients were divided into a formation group (27 cases) and a non-formed group (111 cases). All the clinical baseline data and laboratory examination indicators were reviewed. The univariate and multivariate logistic regressions were used to analyze the factors of intrastent thrombosis within 6 months after PCI for the patients with ST-segment elevation myocardial infarction. The receiver operating characteristic curve (ROC) was used to analyze the value of miR-374a-5p in determining the intrastent thrombosis within 6 months after PCI for the patients with ST-segment elevation myocardial infarction. Results　There were no statistical differences in the gender, age, body mass index (BMI), history of hypertension, history of hyperlipidemia, site of infarction, emergency PCI time, total cholesterol (TC), triacylglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP), diastolic blood pressure (DBP), hemoglobin (Hb), platelet count (PLT), heart rate (HR), and left ventricular ejection fraction (LVEF) between the formation group and the non-formed group (all P>0.05). The proportions of the patients with diabetes history and multiple stentings and the serum miR-374a-5p level in the formation group were higher than those in the non-formed group, with statistical differences (all P<0.05). The area under the ROC was 0.699; the standard error was 0.049; the significance was <0.001; the progressive 95% confidence interval was 0.604-0.795; the miR-374a-5p cut-off point of intrastent thrombosis within 6 months after PCI surgery in the patients was 1.115, indicating that miR-374a-5p had good diagnostic value. Logistic regression analysis showed that history of diabetes, multiple stentings, and miR-374a-5p could be used as risk factors for intrastent thrombosis within 6 months after PCI in the patients with ST-segment elevation myocardial infarction (all P<0.05). Conclusions History of diabetes, multiple stentings, and miR-374a-5p can be used as risk factors for inrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction. The detection of miR-374a-5p level can evaluate the prognosis of patients with ST-segment elevation myocardial infarction.

Key words:

ST-segment elevation myocardial infarction, MiR-374a-5p, Percutaneous coronary intervention, Thrombosis, Prognosis

摘要：

目的　探究与分析miR-374a-5p与急性ST段抬高型心肌梗死患者经皮冠状动脉介入术（PCI）后6个月内支架内血栓形成的关系。方法　回顾性分析晋城市人民医院2020年4月至2022年3月收治的实施PCI治疗的急性ST段抬高型心肌梗死患者138例的临床资料，按照术后6个月是否出现了支架内血栓形成分为形成组（27例）及未形成组（111例），查阅患者的临床基线资料以及实验室检查指标等，采用单因素及多因素logistic回归分析ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的影响因素；采用受试者工作特征曲线（ROC）分析miR-374a-5p在判断ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的价值。结果　形成组性别、年龄、体质量指数（BMI）、高血压病史、高血脂病史、梗死部位、急诊PCI时间、总胆固醇（TC）、三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、收缩压（SBP）、舒张压（DBP）、血红蛋白（Hb）、血小板计数（PLT）、心率（HR）及左心室射血分数（LVEF）与未形成组相比，差异均无统计学意义（均P>0.05）。与未形成组相比，形成组糖尿病病史比例、多支架置入比例、血清miR-374a-5p水平较高，差异均有统计学意义（均P<0.05）。ROC下面积为0.699，标准误差为0.049，显著性为<0.001，渐进95%置信区间为0.604～0.795，该组患者实施PCI后6个月内发生支架内血栓形成的miR-374a-5p切点为1.115，提示miR-374a-5p具有较好的诊断价值。行logistic回归分析发现，糖尿病病史、多支架置入以及miR-374a-5p可作为ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的高危因素（均P<0.05）。结论　糖尿病病史、多支架置入以及miR-374a-5p可作为ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的高危因素。检测miR-374a-5p水平可辅助评估ST段抬高型心肌梗死患者的预后。

关键词:

ST段抬高型心肌梗死, miR-374a-5p, 经皮冠状动脉介入术, 血栓形成, 预后

Li Jing, Zhou Jing, Pan Sancong.

Relationship between miR-374a-5p and intrastent thrombosis within 6 months after PCI for patients with ST-segment elevation myocardial infarction [J]. International Medicine and Health Guidance News, 2023, 29(12): 1678-1682.

李晶周晶潘三葱.

探究miR-374a-5p与急性ST段抬高型心肌梗死患者PCI后6个月内支架内血栓形成的关系 [J]. 国际医药卫生导报, 2023, 29(12): 1678-1682.

References

[1] Zhang Y, Wang S, Yang S, et al. Rationale and design of the Henan ST elevation myocardial infarction (STEMI) registry: a regional STEMI project in predominantly rural central China [J]. BMC Cardiovasc Disord, 2019, 19(1):271. DOI: 10.1186/s12872-019-1250-9.
[2] 谢楠,李剑,许璨. 老年急性冠脉综合征患者经皮冠状动脉介入治疗术后发生不良心脏事件的危险因素分析[J]. 中国循证心血管医学杂志,2019,11(9):1121-1124. DOI:10.3969/j.issn.1674-4055.2019.09.24.
[3] Zhou L, Kou DQ. Correlation between acute myocardial infarction complicated with cerebral infarction and expression levels of MMP-2 and MMP-9 [J]. Eur Rev Med Pharmacol Sci, 2019, 23(1):297-302. DOI: 10.26355/eurrev_201901_16776.
[4] 中华医学会,中华医学会杂志社,中华医学会全科医学分会,等. ST段抬高型心肌梗死基层诊疗指南(2019年)[J]. 中华全科医师杂志,2020,19(12):1083-1091. DOI:10.3760/cma.j.cn114798-20200904-00961.
[5] Cao C, Zhang Y, Chai Y, et al. Attenuation of sepsis-induced cardiomyopathy by regulation of microRNA-23b is mediated through targeting of MyD88-mediated NF-κB activation [J]. Inflammation, 2019, 42(3):973-986. DOI: 10.1007/s10753-019-00958-7.
[6] 郭晓丽,段亚军,罗文平,等. 不同血运重建程度对冠心病患者临床预后的影响及相关因素分析[J]. 中国循证心血管医学杂志,2020,12(5):547-549,553. DOI:10.3969/j.issn. 1674-4055.2020.05.11.
[7] 韩娟萍,张卫泽,张汉平,等. 氯吡格雷联合替罗非班用于STEMI患者PCI术后的抗血小板治疗及对血清炎症因子的影响[J]. 检验医学与临床,2020,17(10):1410-1413. DOI:10.3969/j.issn.1672-9455.2020.10.028.
[8] 梁峰,胡大一,方全,等. 急性ST段抬高型心肌梗死的再灌注治疗[J]. 中国循证心血管医学杂志,2019,11(3):263-274. DOI:10.3969/j.issn.1674-4055.2019.03.02.
[9] 贾静静,赵劲东,董平栓,等. 合并多支血管病变的ST段抬高型心肌梗死血运重建策略的Meta分析[J]. 中国循证心血管医学杂志,2020,12(3):269-274. DOI:10.3969/j.issn. 1674- 4055.2020.03.04.
[10] 周函,黄文胜,冷利华,等. 血浆miR-577水平对急性ST段抬高心肌梗死预后评估的价值分析[J]. 中国循证心血管医学杂志,2020,12(5):543-546. DOI:10.3969/j.issn.1674- 4055. 2020.05.10.
[11] 屠袁园,赵菊伟. 急性ST段抬高型心肌梗死患者冠脉介入治疗后近期预后的相关影响因素分析[J]. 中国卫生统计,2019,36(3):392-394.
[12] Tafrihi M, Hasheminasab E. MiRNAs: biology, biogenesis, their web-based tools, and databases [J]. Microrna, 2019,8(1):4-27. DOI: 10.2174/2211536607666180827111633.
[13] Chichareon P, Modolo R, van Klaveren D, et al. Predictive ability of ACEF and ACEF Ⅱ score in patients undergoing percutaneous coronary intervention in the GLOBAL LEADERS study [J]. Int J Cardiol, 2019, 286:43-50. DOI: 10.1016/j.ijcard.2019.02.043.
[14] 周鹏,董金永. 入院应激性高血糖与糖化血红蛋白对行PCI治疗后糖尿病合并STEMI病人左心室功能及炎性因子的影响[J]. 中西医结合心脑血管病杂志,2020,18(20):3391-3395. DOI:10.12102/j.issn.1672-1349.2020.20.016.
[15] Pelliccia F, Gaudio C. The ACEF score in patients undergoing percutaneous coronary intervention: "keep it simple and focus on what matters" [J]. Int J Cardiol, 2019, 286:54-55. DOI: 10.1016/j.ijcard.2019.03.023.
[16] 毛美娇,赵英利,邓兵,等. 疏血通注射液对急性STEMI患者PCI术后冠脉微循环及血清ICAM-1、 TNF-α、hs-CRP水平的影响[J]. 上海中医药大学学报,2021,35(5):7-13. DOI:10.16306/j.1008-861x.2021.05.002.
[17] 王骥飞,房超,杨光,等. STEMI患者炎症反应水平及罪犯斑块特征与PCI术前TIMI血流分级的关系[J]. 中华心血管病杂志,2021,49(2):150-157. DOI:10.3760/cma.j.cn112148-20200531-00452.
[18] 石晓辉,左红,魏亚静,等. 改良PCI方案对老年STEMI患者的心功能及围术期不良事件的影响[J]. 心血管康复医学杂志,2021,30(2):185-189. DOI:10.3969/J,issn.1008-0074. 2021.02.16.
[19] Yuan Y, Liu X, Hao S, et al. Plasma levels of miR-143 and miR-145 are associated with coronary in-stent restenosis within 1 year of follow-up after drug-eluting stent implantation [J]. Ann Transl Med, 2020, 8(12):756. DOI: 10.21037/atm-20-4227.