Predictive value of serum circRNA CDYL and circRNA ACAP2 expression levels for major adverse cardiovascular events in patients with acute myocardial infarction
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摘要:目的
探讨血清环状RNA(circRNA) CDYL、circRNA ACAP2表达水平对急性心肌梗死(AMI)患者主要不良心血管事件(MACE)的预测价值。
方法选取98例AMI患者纳入观察组, 并根据是否发生MACE将患者分为MACE组(n=45)和无MACE组(n=53)。另选取同期体检的健康者98例纳入对照组。比较各组患者血清circRNA CDYL、circRNA ACAP2的表达水平。采用多因素Logistic回归分析法筛选AMI患者发生MACE的影响因素。采用受试者工作特征(ROC)曲线分析血清circRNA CDYL、circRNA ACAP2水平对AMI患者发生MACE的预测价值。
结果观察组血清circRNA CDYL水平低于对照组，circRNA ACAP2水平高于对照组，差异有统计学意义(P < 0.05)。MACE组血清circRNA CDYL水平低于无MACE组, circRNA ACAP2水平高于无MACE组，差异有统计学意义(P < 0.05)。心率、circRNA ACAP2为AMI患者发生MACE的独立危险因素, circRNA CDYL为独立保护因素(P < 0.05)。血清circRNA CDYL、circRNA ACAP2及其联合预测AMI患者发生MACE的曲线下面积(AUC)分别为0.814、0.821、0.921。血清circRNA CDYL、circRNA ACAP2联合预测的敏感度为91.11%, 特异度为79.25%。血清circRNA CDYL、circRNA ACAP2联合预测的效能优于其单独预测(Z二者联合-circRNA CDYL=1.975、Z二者联合-circRNA ACAP2=2.064, P=0.048、0.039)。
结论AMI患者血清circRNA CDYL水平下调, circRNA ACAP2水平上调，且circRNA ACAP2为患者发生MACE的独立危险因素, circRNA CDYL为独立保护因素。血清circRNA CDYL、circRNA ACAP2联合预测患者发生MACE的价值较高。
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关键词:
- 急性心肌梗死 /
- 环状RNA CDYL /
- 环状RNA ACAP2 /
- 主要不良心血管事件 /
- 预测价值
Abstract:ObjectiveTo investigate the predictive value of serum circular RNA (circRNA) CDYL and circRNA ACAP2 expression levels for major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI).
MethodsA total of 98 AMI patients were enrolled into the observation group, and divided into MACE group (n=45) and no-MACE group (n=53) based on whether they experienced MACE. Another 98 healthy individuals who underwent physical examination during the same period were selected as the control group. The expression levels of serum circRNA CDYL and circRNA ACAP2 were compared among groups. Multivariate logistic regression analysis was used to identify factors influencing the occurrence of MACE in AMI patients. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the predictive value of serum circRNA CDYL and circRNA ACAP2 levels for MACE in AMI patients.
ResultsThe serum circRNA CDYL level in the observation group was significantly lower than that in the control group, while the circRNA ACAP2 level was significantly higher (P < 0.05). The circRNA CDYL level in the MACE group was significantly lower, and the circRNA ACAP2 level was significantly higher than that in the no-MACE group (P < 0.05). Heart rate and circRNA ACAP2 were identified as independent risk factors for MACE in AMI patients, whereas circRNA CDYL served as independent protective factor (P < 0.05). The area under the ROC curve (AUC) for predicting MACE in AMI patients using serum circRNA CDYL, circRNA ACAP2 and their combination were 0.814, 0.821 and 0.921, respectively. The sensitivity and specificity of combined prediction using serum circRNA CDYL and circRNA ACAP2 were 91.11% and 79.25%, respectively. The combined prediction efficacy of serum circRNA CDYL and circRNA ACAP2 was superior to their individual prediction (Zcombined-circRNA CDYL = 1.975, Zcombined-circRNA ACAP2 = 2.064, P=0.048, 0.039).
ConclusionSerum circRNA CDYL level is down-regulated and circRNA ACAP2 level is up-regulated in AMI patients, and circRNA ACAP2 is an independent risk factor for MACE, while circRNA CDYL is a independent protective factor. The combined value of circRNA CDYL and circRNA ACAP2 in predicting the occurrence of MACE is higher.
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表 1 观察组和对照组血清circRNA CDYL、ircRNA ACAP2水平比较(x±s)
组别 n circRNA CDYL circRNA ACAP2 观察组 98 0.58±0.14* 2.15±0.39* 对照组 98 1.09±0.27 1.11±0.24 与对照组比较, *P < 0.05。 
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表 2 MACE组与无MACE组临床资料比较[WTBZ][n(%)](x±s)
临床资料 分类 MACE组(n=45) 无MACE组(n=53) t/χ2 P 年龄/岁 56.62±6.47 56.01±6.31 0.471 0.638 性别 男 24(53.33) 31(58.49) 0.263 0.608 女 21(46.67) 22(41.51) 体质量指数/(kg/m2) 23.58±3.72 23.74±3.29 0.226 0.822 收缩压/mmHg 135.49±13.68 134.77±13.80 0.258 0.797 舒张压/mmHg 85.62±9.27 84.34±9.45 0.674 0.502 心率/(次/min) 81.87±8.88 78.24±8.51 2.063 0.042 高血压 有 17(37.78) 15(28.30) 0.994 0.319 无 28(62.22) 38(71.70) 糖尿病 有 14(31.11) 13(24.53) 0.528 0.467 无 31(68.89) 40(75.47) 吸烟史 有 29(64.44) 35(66.04) 0.027 0.869 无 16(35.56) 18(33.96) 饮酒史 有 25(55.56) 33(62.26) 0.453 0.501 无 20(44.44) 20(37.74) 冠状动脉病变程度 单支病变 20(44.44) 22(41.51) 0.087 0.957 双支病变 16(35.56) 20(37.74) 多支病变 9(20.00) 11(20.75) 冠状动脉狭窄程度 < 75% 9(20.00) 12(22.64) 0.101 0.751 ≥75% 36(80.00) 41(77.36) 1 mmHg=0.133 kPa。
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表 3 MACE组和无MACE组血清circRNA CDYL、circRNA ACAP2水平比较(x±s)
组别 n circRNA CDYL circRNA ACAP2 MACE组 45 0.43±0.12* 2.52±0.43* 无MACE组 53 0.71±0.16 1.83±0.36 与无MACE组比较, *P < 0.05。
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表 4 多因素Logistic回归分析法筛选患者发生MACE的影响因素
指标 β SE Wald P OR 95%CI circRNA CDYL -0.364 0.168 4.690 0.030 0.695 0.500~0.966 circRNA ACAP2 0.846 0.404 4.388 0.036 2.331 1.056~5.146 心率 0.721 0.355 4.128 0.042 2.057 1.026~4.125
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表 5 血清circRNA CDYL、circRNA ACAP2水平对患者发生MACE的预测价值
变量 AUC 截断值 95%CI 敏感度/% 特异度/% Youden指数 circRNA CDYL 0.814 0.56 0.723~0.885 77.78 84.91 0.627 circRNA ACAP2 0.821 1.96 0.730~0.891 77.78 81.13 0.589 二者联合 0.921 — 0.849~0.966 91.11 79.25 0.704
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[1] 董松武, 张静. 急性心肌梗死病人血浆中微小RNA-21定量检测及其临床意义[J]. 安徽医药, 2020, 24(2): 337-341. [2] 林丹凤, 陈艳俏, 牛卫洲. 急性心肌梗死病人血清微RNA-1283表达与中医证型的关系分析[J]. 安徽医药, 2023, 27(7): 1342-1345. [3] LIANG F, WANG Y. Coronary heart disease and atrial fibrillation: a vicious cycle[J]. Am J Physiol Heart Circ Physiol, 2021, 320(1): H1-H12.
[4] CHEN F, WANG X H, FU S, et al. Circular RNA circ-CDYL sponges miR-1180 to elevate yes-associated protein in multiple myeloma[J]. Exp Biol Med (Maywood), 2020, 245(11): 925-932.
[5] 周燕, 唐云龙, 刘佳琦, 等. Circ-CDYL通过miR-223-3p/PHF19轴调节多发性骨髓瘤对硼替佐米的敏感性[J]. 国际检验医学杂志, 2023, 44(10): 1229-1234. [6] CUI W, DAI J H, MA J B, et al. circCDYL/microRNA-105-5p participates in modulating growth and migration of colon cancer cells[J]. Gen Physiol Biophys, 2019, 38(6): 485-495. doi: 10.4149/gpb_2019037
[7] 庄玉芬, 张玉丹, 陈成辉. circRNA ACAP2在乳腺癌中的表达水平及其与患者预后的关系[J]. 热带医学杂志, 2023, 23(11): 1558-1562. doi: 10.3969/j.issn.1672-3619.2023.11.013 [8] LIU X, WANG M X, LI Q, et al. CircRNA ACAP2 induces myocardial apoptosis after myocardial infarction by sponging miR-29[J]. Minerva Med, 2022, 113(1): 128-134.
[9] 中国医师协会急诊医师分会, 国家卫健委能力建设与继续教育中心急诊学专家委员会, 中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中华急诊医学杂志, 2019, 28(4): 421-428. doi: 10.3760/cma.j.issn.1671-0282.2019.04.003 [10] 刘相应, 唐良秋, 范文茂, 等. 直接经皮冠状动脉介入治疗术前、术后血清心型脂肪酸结合蛋白水平与急性ST段抬高心肌梗死患者预后的相关性[J]. 中国介入心脏病学杂志, 2016, 24(8): 433-438. [11] 王蔚文, 孙明. 临床疾病诊断与疗效判断标准[M]. 北京: 科学技术文献出版社, 2010: 120-125. [12] 王茜, 杜青. 24 h动态心电图联合NT-pro、hs-CRP对急性心肌梗死后恶性心律失常的预测价值[J]. 贵州医药, 2024, 48(4): 611-613. [13] 中国医师协会心血管内科医师分会, 中国心血管健康联盟, 心肌梗死后心力衰竭防治专家共识工作组. 2020心肌梗死后心力衰竭防治专家共识[J]. 中国循环杂志, 2020, 35(12): 1166-1180. [14] KAPUR N K, THAYER K L, ZWECK E. Cardiogenic shock in the setting of acute myocardial infarction[J]. Methodist Debakey Cardiovasc J, 2020, 16(1): 16-21.
[15] 常丽辉, 王绍伟, 赵伟波. D-二聚体、GDF-15、HSP对AMI患者PCI术后并发MACE的预测价值及与预后的关系[J]. 国际检验医学杂志, 2023, 44(14): 1748-1751, 1755. [16] 吴玉. 血栓相关指标检测对急性心肌梗死患者发生主要不良心血管事件的预测价值[J]. 中国当代医药, 2023, 30(2): 163-166, 170. [17] LIANG G H, LING Y, LIN Q, et al. miR-92b-3p inhibits proliferation of HER2-positive breast cancer cell by targeting circCDYL[J]. Front Cell Dev Biol, 2021, 9: 707049.
[18] MEI M, WANG Y J, WANG Q L, et al. CircCDYL serves as a new biomarker in mantle cell lymphoma and promotes cell proliferation[J]. Cancer Manag Res, 2019, 11: 10215-10221.
[19] ZHANG M, WANG Z, CHENG Q S, et al. Circular RNA (circRNA) CDYL induces myocardial regeneration by CeRNA after myocardial infarction[J]. Med Sci Monit, 2020, 26: e923188.
[20] MA C, SHI T T, QU Z L, et al. CircRNA_ACAP2 suppresses EMT in head and neck squamous cell carcinoma by targeting the miR-21-5p/STAT3 signaling axis[J]. Front Oncol, 2020, 10: 583682.
[21] ZHU J, XIANG X L, CAI P, et al. CircRNA-ACAP2 contributes to the invasion, migration, and anti-apoptosis of neuroblastoma cells through targeting the miRNA-143-3p-hexokinase 2 axis[J]. Transl Pediatr, 2021, 10(12): 3237-3247.
[22] ZHANG J, TANG Y R, ZHANG J, et al. CircRNA ACAP2 is overexpressed in myocardial infarction and promotes the maturation of miR-532 to induce the apoptosis of cardiomyocyte[J]. J Cardiovasc Pharmacol, 2021, 78(2): 247-252.
[23] CHANDRASEKERA D N K, NEALE J P H, VAN HOUT I, et al. Upregulation of microRNA-532 enhances cardiomyocyte apoptosis in the diabetic heart[J]. Apoptosis, 2020, 25(5/6): 388-399.
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