Effects of miRNA-1,miRNA-21 in plasma on in-stent restenosis in patients with coronary heart disease and diabetes mellitus after percutaneous coronary intervention

Abstract

To observe the expression differences of the plasma miRNA-1, miRNA-21 between patients with coronary heart disease (CHD) and without coronary artery lesions, between patients with in-stent restenosis (ISR) and none in-stent restenosis (NISR), and to study their predictive value for ISR occurred after percutaneous coronary intervention (PCI) in patients with CHD and diabetes mellitus (DM). The selected subjects were divided into CHD group in which patients were implemented stenting (n=187), and control group in which patients were without coronary artery lesions (n=195). According to the guidelines, the control group was divided into normal group (n=150), simple-DM group (n=45); the CHD group was divided into simple-CHD group (n=119) and CHD-DM group (n=68), the CHD group was also divided into ISR group (n=48), NISR group (n=139), and the ISR group was divided into simple-ISR group (n=26) and ISR-DM group (n=22) again. Plasma was collected from each group, and total RNA was extracted, the level of blood miRNA-1, miRNA-21 of each group was detected, and their level differences were analyzed. Compared with control group, the level of miRNA-1 and miRNA-21 of CHD group was increased (P<0.05); compared with NISR group, the level of miRNA-1 and miRNA-21 of ISR group was increased (P<0.05). The incidence of ISR of CHD-DM group was obviously higher than that of simple-CHD group, ISR-DM group's level of miRNA-21 was higher than that of simple-ISR group (P<0.05), and there was no difference of miRNA-1 level between ISR and ISR-DM group (P<0.05). In Logistics, for CHD patents, the OR of DM, miRNA-1, miRNA-21 were 2.132, 3.066, 1.924 respectively (P<0.05); for CHD patents with ISR, the OR of DM, miRNA-21 were 2.123, 3.066 respectively (P<0.05); especially for CHD and DM patents with ISR, the OR of miRNA-21 was 9.148 (P<0.05). In ROC curve, for CHD patients with ISR, the AUC of miRNA-1, miRNA-21 were 0.854, 0.857 respectively; for CHD-DM patients with ISR, the AUC of miRNA-21 was 0.783. To predict the occurrence of ISR for CHD patients, the plasma miRNA-1 and miRNA-21 have a relatively high specificity and sensitivity, for CHD patients with DM, miRNA-21 may have a higher clinical value.