Abstract
Circulating miR-186-5p is an emerging biomarker for acute coronary syndrome (ACS) patients. However, its kinetic signatures and prognostic values in ACS patients undergoing percutaneous coronary intervention (PCI) remain unclear. Levels of serum miR-186-5p were determined in 96 healthy controls and 92 ACS patients before and after PCI by qRT-PCR, and the physiologic state of miR-186-5p was analyzed by comparing its absolute concentrations in isolated exosomes and exosome-depleted supernatants. An average of 1 year of follow-up for ACS patients after PCI was performed. MiR-186-5p levels in the myocardium and serum of rats following left anterior descending coronary artery (LAD) ligation were measured. Serum miR-186-5p levels were found to be significantly increased in ACS patients upon admission compared with those of controls, but these high miR-186-5p levels gradually decreased within 1 week after PCI. Serum miR-186-5p was mainly present in an exosome-free form rather than membrane-bound exosomes. Within 1 year of follow-up, ACS patients with higher miR-186-5p levels upon admission exhibited a higher incidence of MACE after PCI. Different statistical analyzes further validated the independent prognostic values of serum miR-186-5p in ACS patients after PCI. Serum miR-186-5p levels in rats following LAD ligation were increased, and there was a decrease in myocardial miR-186-5p levels. Kyoto encyclopedia of genes and genomes (KEGG) analysis was performed to predict the related pathways of target genes of miR-186-5p, which suggested that miR-186-5p might be involved in ACS by regulating the inflammatory status and D-glucose metabolism. In conclusion, a distinctive expression signature of serum miR-186-5p may contribute to monitoring the clinical condition and assessing the prognosis of ACS patients undergoing PCI.
Highlights
Ischemic heart disease (IHD) is one of the leading causes of morbidity and mortality worldwide, and ischemic heart disease has caused the most global deaths in the last few decades (GBD 2016 Causes of Death Collaborators, 2017)
A total of 188 subjects, including 92 Acute coronary syndrome (ACS) patients and 96 healthy controls were enrolled in this study
Logistic regression analyses analysis revealed that serum miR-186-5p may be considered an independent risk factor for ACS presence, and the current study indicated the potential utility of serum miR-186-5p as an ischemia/reperfusion monitoring biomarker of ACS patients via percutaneous coronary intervention (PCI)
Summary
Ischemic heart disease (IHD) is one of the leading causes of morbidity and mortality worldwide, and ischemic heart disease has caused the most global deaths in the last few decades (GBD 2016 Causes of Death Collaborators, 2017). Acute coronary syndrome (ACS), the main form of IHD and the most serious medical emergency, occurs as a result of myocardial ischemia after unstable coronary atherosclerotic plaque formation, and its clinical presentations include acute myocardial infarction (AMI) and unstable angina (UA) (Carreras and Mega, 2015). Percutaneous coronary intervention (PCI) is the mainstay of treatment for ACS to restore coronary perfusion and reduce infarct size during acute myocardial ischemia (O’Gara et al, 2013). There is still a lack of highly sensitive and specific approaches to monitor the clinical condition and assess the prognosis of ACS patients. This current situation underscores the need for further exploration of reliable biomarkers that could reflect improvement of cardiac function in ACS patients after reperfusion therapy
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