Abstract
Acute coronary syndrome (ACS) is a serious threat to public health. Based on clinical manifestations, ACS can be classified into unstable angina (UA) pectoris and acute myocardial infarction (AMI). The purpose of this study was to explore the possibility of using serum exosomal microRNA (miR)-126, miR-21, and phosphatase and tensin homolog (PTEN) expression levels as biomarkers of UA and AMI and to investigate whether these levels were positively correlated with the severity of coronary stenosis based on the Gensini score. Exosomes were isolated by ultracentrifugation from the serum of 34 patients with AMI, 31 patients with UA, and 22 healthy controls. The isolated exosomes were characterized by electron microscopy and particle size analysis; exosomal identity was further confirmed by western blotting using exosome-specific antibodies. Real-time quantitative polymerase chain reaction indicated that the serum exosomal levels of miR-126 and miR-21 were significantly higher in the patients with UA and AMI than in the healthy controls. Enzyme-linked immunosorbent assay showed that the serum exosomal PTEN levels were significantly higher in the UA and AMI groups than in the control group. Receiving operating characteristic curve analysis demonstrated the diagnostic efficiency of serum exosomal miR-126, miR-21, and PTEN levels for predicting AMI and UA. In addition, the circulating exosomal miR-126 level was positively correlated with the severity of coronary artery stenosis in patients with UA and AMI based on the Gensini score.
Highlights
Coronary heart disease is the main cause of death in adults in the United States, accounting for one-third of all deaths among adults over 35 years old (Sanchis-Gomar et al, 2016)
In this study, we investigated whether the exosomal levels of miR-21, miR-126, and phosphatase and tensin homolog (PTEN) extracted from patient serum samples can be used as diagnostic markers for acute myocardial infarction (AMI) and unstable angina (UA) and whether these indices are related to the severity of coronary artery stenosis
Acute coronary syndrome (ACS) is the most serious type of coronary heart disease, and has received substantial research attention in recent years to improve prevention, early diagnosis, and treatment. This effort has revealed that serum miR-499 and miR-210 can be used as biomarkers for the diagnosis of symptoms in patients with UA and non-ST segment elevation myocardial infarction within 3 h (Shalaby et al, 2016) and circulating miR-208 was suggested as a potential biomarker for the diagnosis of ACS (Wang et al, 2019)
Summary
Coronary heart disease is the main cause of death in adults in the United States, accounting for one-third of all deaths among adults over 35 years old (Sanchis-Gomar et al, 2016). The diagnosis of AMI is based on clinically abnormal levels of certain cardiac biomarkers, including troponin, which is a Diagnostic Markers for ACS cardiac biomarker acute myocardial ischemia. It takes 3–4 h for the troponin level to increase after the occurrence of myocardial infarction. It has been found that patients with heart failure, hypertension and cardiac perioperative period have the phenomenon of troponin increase (Kociol et al, 2010; Roffi et al, 2016; Lionetti and Barile, 2020) so troponin is not specific enough in term of the diagnosis of AMI. There is still no reliable biomarker for the diagnosis of UA
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