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血清环状RNA CDYL、环状RNA ACAP2水平预测急性心肌梗死患者发生主要不良心血管事件的价值

Predictive value of serum circRNA CDYL and circRNA ACAP2 expression levels for major adverse cardiovascular events in patients with acute myocardial infarction

    摘要
  • 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。

     

    Abstract:
    Objective To 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).
    Methods A 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.
    Results The 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).
    Conclusion Serum 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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