血清微小RNA-20a和自噬相关基因7对急性ST段抬高型心肌梗死患者经皮冠状动脉介入治疗后主要不良心血管事件的预测

目的探讨血清微小RNA(miR)-20a和自噬相关基因7(ATG7)对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)后主要不良心血管事件(MACE)的预测价值。方法纳入行PCI的初发急性STEMI患者233例,根据院内预后情况分为MACE组64例和非MACE组169例。比较两组患者血清氨基末端脑钠肽前体(NT-proBNP)、Ⅲ型前胶原氨端肽(PⅢNP)、ATG7及miR-20a水平并分析其相关性。结果MACE组患者年龄、NT-proBNP、PⅢNP、ATG7水平及Killip心功能Ⅳ级患者比例均高于非MACE组,血清miR-20a水平低于非MACE组(P<0.05)。多因素logistic回归分析结果显示,高龄、Killip心功能Ⅳ级、NT-proBNP、PⅢNP及ATG7水平升高是急性STEMI患者PCI后发生院内MACE的独立危险因素,而血清miR-20a水平升高是其独立保护因素(P<0.05)。Pearson相关分析结果显示,血清miR-20a与ATG7、NT-proBNP、PⅢNP均呈负相关(P<0.05),而血清ATG7与NT-proBNP、PⅢNP均呈正相关(P<0.05)。受试者工作特征(ROC)曲线分析结果显示,血清miR-20a联合ATG7预测急性STEMI患者PCI后发生院内MACE的价值高于血清miR-20a和ATG7。结论血清miR-20a和ATG7均与NT-proBNP、PⅢNP密切相关,是急性STEMI患者PCI后发生院内MACE的独立预测因素。

Prediction of serum microRNA-20a and autophagy related gene 7 on major adverse cardiovascular event in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

Objective To explore predictive value of serum microRNA(miR)-20a and autophagy related gene 7(ATG7) on major adverse cardiovascular event(MACE) in patients with acute ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI).Methods According to in-hospital prognosis,233 patients with newly diagnosed acute STEMI undergoing PCI were divided into MACE group(64 cases) and non-MACE group(169 cases).Serum amino terminal pro-brain natriuretic peptide(NT-proBNP),type Ⅲ procollagen amino terminal peptide(PⅢNP),ATG7 and miR-20a levels were compared and to analyze their correlation.Results Age,NT-proBNP,PⅢNP,ATG7 levels and ratio of patients with Killip cardiac function grade Ⅳ in MACE group were higher than those in non-MACE group,while serum miR-20a level was lower than that in non-MACE group(P<0.05).Multivariate logistic regression analysis showed that elevated age,Killip cardiac function grade Ⅳ,NT-proBNP,PⅢNP and ATG7 levels were independent risk factors for in-hospital MACE after PCI in patients with acute STEMI,and elevated serum miR-20a level was an independent protective factor for it（P<0.05).Pearson correlation analysis showed that serum miR-20a was negatively correlated with ATG7,NT-proBNP and PⅢNP(P<0.05)，while serum ATG7 was positively correlated with NT-proBNP and PⅢNP（P<0.05).Receiver operating characteristic(ROC) curve analysis showed that value of serum miR-20a combined with ATG7 predicted in-hospital MACE in patients with acute STEMI after PCI was higher than serum miR-20a and ATG7.Conclusion Serum miR-20a and ATG7 are closely related with NT-proBNP and PⅢNP and are independent predictive factors of in-hospital MACE in patients with acute STEMI after PCI.