Plasma miR-126 as a potential marker predicting major adverse cardiac events in dual antiplatelet-treated patients after percutaneous coronary intervention.
Plasma miR-126 as a potential marker predicting major adverse cardiac events in dual antiplatelet-treated patients after percutaneous coronary intervention.
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DOI：
10.4244/eijv9i5a90
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发表时间：
2013-09
期刊：
影响因子：
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通讯作者：
Xi-yong Yu;Ji-yan Chen;Zhi-Wei Zheng;Hong Wu;Li-wen Li-Li-wen-Li-2145648339;Zhi-wei Zhang;Zhihong Chen;Q. Lin
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文献类型：
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作者：
Xi-yong Yu;Ji-yan Chen;Zhi-Wei Zheng;Hong Wu;Li-wen Li-Li-wen-Li-2145648339;Zhi-wei Zhang;Zhihong Chen;Q. Lin
抗血小板治疗可引起血小板microRNAs（miRNAs）血浆水平的变化。然而，目前尚不清楚血小板miRNAs的血浆水平是否可以预测抗血小板治疗的临床结果。本研究旨在评估经皮冠状动脉介入治疗（PCI）后双重抗血小板治疗患者血浆miR-16、miR-126、miR-26 b和miR-223与临床结局风险的相关性。方法和结果共491例接受PCI和双重抗血小板治疗的中国汉族患者被依次招募到研究中，并随访长达一年。通过定量逆转录PCR测定PCI后第二天清晨5种候选miRNA的血浆浓度。评估血浆miRNA水平对1年内主要不良心血管事件（MACE）和6个月内出血的影响。我们发现，较高的血浆miR-126水平与至MACE时间的较高风险显著相关。与前三个四分位数中的血浆miR-126水平相比，第四个四分位数中的血浆miR-126水平的风险比（HR）为2.61（95% CI：1.32-5.18，p=0.006）。多因素考克斯回归分析显示，糖尿病、射血分数、高血压和血浆miR-126水平升高是MACE的独立危险因素。血浆miR-223水平不是MACE的独立预测指标。在6个月的随访期间，5种血浆miRNAs的水平与出血事件之间没有显著相关性。结论：基于这些结果，我们认为血浆miR-126可能是预测PCI术后患者主要不良心脏事件的潜在标志物。
AIMS Antiplatelet treatment can cause a change in plasma levels of platelet microRNAs (miRNAs). However, it is not clear whether the plasma level of platelet miRNAs can predict clinical outcomes of antiplatelet treatment. The present study aimed to evaluate the association of plasma miR-16, miR%E2%80%9121, miR-126, miR-26b, and miR-223 with the risk of clinical outcomes in dual antiplatelet-treated patients after percutaneous coronary intervention (PCI). METHODS AND RESULTS A total of 491 Han Chinese patients who had received PCI and dual antiplatelet therapy were sequentially recruited to the study and followed for up to one year. Plasma concentrations of five candidate miRNAs early the next morning after PCI were determined by quantitative reverse transcription PCR. The effect of the plasma miRNA level on major adverse cardiovascular events (MACE) within one year and bleeding within six months were assessed. We found that a higher plasma miR-126 level was significantly associated with a higher risk in terms of time-to-MACE. When compared with the plasma miR-126 level in the first three quartiles, the hazard ratio (HR) for the plasma miR-126 level in the fourth quartile was 2.61 (95% CI: 1.32-5.18, p=0.006). Multivariable Cox regression analysis showed that diabetes mellitus, ejection fraction, hypertension and a higher plasma miR-126 level were independent risk factors for MACE. Plasma miR-223 level was not an independent predictive marker for MACE. There was no significant association between the level of five plasma miRNAs and bleeding events during six-month follow-up. CONCLUSIONS Based on these results, we suggest that plasma miR-126 could be a potential marker for predicting major adverse cardiac events in patients after PCI.