Abstract
PurposeThis study was designed to explore the value of monitoring miR-92a in T2DM patients with coronary heart disease (CHD).Materials and methods40 ACS patients with prior history of CHD and diabetes while the onset time of diabetes preceded that of CHD by more than 2 years were enrolled as the DACS group(diabetic ACS group). 40 ACS subjects who had had a definite diagnosis of CHD for more than 2 years with no history of T2DM were recuited as the CACS group(chronic CHD with ACS group). All enrolled subjects from DACS and CACS group came from an emergency basis and diagnosed with ACS by coronary angiography. Another 68 age- and sex-matched volunteers with chronic stable CHD without diabetes history were assigned as the control group (CHD group). We examined the serum levels of miR-92a and analyzed their correlations with blood pressure, glucose level, and lipid level.ResultsThe levels of miR-92a were significantly elevated in the DACS group compared with those of the CACS and CHD groups. Multivariate analysis showed that miR-92a, systolic blood pressure (SBP), and glycosylated hemoglobin (HbA1c) were significantly related to ACS events in patients with T2DM. Forward stepwise binary logistic regression analysis identified miR-92a as an independent predictive factor for ACS events in the patients with T2DM.ConclusionAn elevated circulating miR-92a level was associated with an increased risk of ACS in CHD patients with T2DM. Thus the level of miR-92a, especially combined with elevated SBP and HbA1c, may be helpful in the detection of ACS in patients with T2DM.
Highlights
Acute coronary syndrome (ACS) is an acute cardiac ischemic syndrome due to coronary artery atherosclerotic thrombosis involving the rupture or erosion of unstable plaques [1]
The Glycated hemoglobin (HbA1c) was 4.68% (IQR 4.47–4.94%) in the coronary heart disease (CHD) controls, 5.35% (IQR,4.78–5.86%) in the CACS group, and 8.00% (IQR 7.27–9.60%) in the DACS group. Both random blood glucose (RBG) and HbA1c were dramatically increased in the CACS and DACS groups compared with the CHD control group (P < 0.001)
The CACS and DACS groups had higher levels of triglyceride (TG) and total cholesterol (TC) than the CHD control group (P < 0.001). Both high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were dramatically decreased in the DACS group compared with the CACS group, with 88.57% of the patients in the CACS group having normal levels of statins compared with 95.73% in the DACS group (Table 1)
Summary
Acute coronary syndrome (ACS) is an acute cardiac ischemic syndrome due to coronary artery atherosclerotic thrombosis involving the rupture or erosion of unstable plaques [1]. In studies of ACS in T2DM (referred to here as diabetic ACS, or DACS), miR-92a attracts particular attention because it is a newly recognized biomarker of ACS [13] and hyperglycemia [16] in patients with CHD; it regulates neovascularization, and the inhibition of miR-92a enhances angiogenesis [17]. There is compelling evidence that miR-92a plays a role in the pathogenesis of ACS and that high levels of expression of miR-92a can serve as a potential biomarker to differentiate between patients with stable CAD and those with acute myocardial infarction (AMI). In order to test this hypothesis, we studied both the expression pattern and clinical relevance of circulating miR-92a with T2DM in CHD and ACS patients with T2DM
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