易损斑块作为急性冠脉综合征(ACS)的病理基础,可导致急性心血管事件。但临床上缺乏早期诊断易损斑块的有效手段。microRNA(miRNA)是一类非编码小分子RNA,具有疾病特定表达模式,可在血中检出。最新研究提示miRNA与心血管疾病关系密切,可能成为预测ACS的新型生物标志物。本研究在既往工作基础上,应用高通量miRNA芯片筛查ACS患者和对照者循环miRNA表达谱,获得循环差异miRNAs；进而分析循环差异miRNAs与易损斑块临床评估指标(影像指标、传统危险因素等)的相关性,并应用受试者工作特征曲线评价循环差异miRNA诊断易损斑块的临床价值；此外在动脉粥样硬化组织和细胞中,研究循环差异miRNAs的细胞来源、分泌机制和调控因素。旨在鉴定出一组循环miRNAs,并阐明其存在形式及释放机制,为易损斑块的早期诊断提供一种敏感、特异和简单的新技术,为miRNAs向临床应用转化提供依据。

Acute coronary syndrome (ACS) which are the most intensive manifestation of coronary artery disease (CAD), are a major cause of mortality and morbidity, and most are caused by rupture and thrombosis of vulnerable atherosclerotic plaques.Identification of such high-risk vulnerable patients with new/established screening tools (traditional risk factors, biomarkers and vascular imaging tools) is improving although still imperfect. MicroRNAs (miRNAs) are approximately 20- to 25-nt-long noncoding RNAs that negatively regulate gene expression by binding to sites in the 3' untranslated region (UTRs) of targeted messenger RNAs. The recent discovery that miRNAs are present in the circulation and miRNAs are very likely involved in the pathogenesis of vulnerable plaque sparked interest in their use as potential prewarning biomarkers of ACS.In this study, on the basis of previous work,we will perform an miRNA arrays analysis between ACS patients and controls to obtain differential expressing miRNAs in the circulation.The association between circulating differential expressing miRNAs and clinical assessment index on vulnerable plaque (image results, traditional risk factors, etc.) , and the diagnostic value of circulating miRNAs on vulnerable plaque with the application of receiver operating characteristic curve would be further evaluated.In addition, the source, secretion mechanisms and regulatory factors of these differential expressing miRNAs would be studied in atherosclerotic tissues and cells.The objective of our study is to identify a unique signature of circulating miRNAs for early diagnosis of vulnerable plaque, and to provide a sensitive , specific and simple new technology for prewarning of ACS and the basis for the translation of circulating miRNAs to clinical application.