Key result
Patients with high circulating miR-660-5p levels had a nearly 6-fold higher risk of no-reflow phenomenon compared to those with low levels (OR 5.68, 95% CI 1.40-23.07, p=0.015).
Why the study?
The study was conducted to investigate the association of circulating miR-660-5p with the no-reflow phenomenon in patients with STEMI undergoing PPCI.
Is high circulating miR-660-5p associated with an increased risk of the no-reflow phenomenon in patients with anterior STEMI undergoing primary percutaneous coronary intervention?
Observational (n=52)
No
Is high circulating miR-660-5p associated with an increased risk of the no-reflow phenomenon in patients with anterior STEMI undergoing primary percutaneous coronary intervention?
Odds Ratio: 5.68 (95% CI 1.4–23.07)
p-value: p=0.015
High circulating levels of miR-660-5p are significantly associated with an increased risk of the angiographic no-reflow phenomenon in patients with anterior STEMI undergoing primary PCI.
Elevated miR-660-5p was associated with no-reflow after primary PCI; hypothesis-generating and requires prospective validation before clinical use.
OBJECTIVE: This study aims to investigate the association of circulating miR-660-5p with no-reflow phenomenon (NRP) in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS: Consecutive patients diagnosed with anterior STEMI within 12 h of pain onset were included; in these patients, coronary angiography confirmed that the left anterior descending artery was infarcted. Angiographic NRP was defined as a final thrombolysis in myocardial infarction (TIMI) flow 2 or 3 with a myocardial blush grade (MBG) <2. High miR-660-5p was defined as a value in the third tertile. The relationship of circulating miR-660-5p with NRP was assessed using Spearman correlation analysis and multiple logistic regression analysis. RESULTS: Fifty-two eligible patients were finally included in this study (mean age: 56±12.4 years, >65 years: 53.8%, male: 76.9%, and mean Body Mass Index: 26.3±3.5). The incidence of NRP was 38.5%. Circulating miR-660-5p was significantly related to the mean platelet volume (MPV). The patients were grouped into tertiles by miR-660-5p levels (Q1: <7.18, Q2: 7.18-11.31, Q3: >11.31). Those in the high microRNA-660-5p group had nearly a 6-fold higher risk of NRP than those in the low microRNA-660-5p group [odds ratio (OR) = 5.68, 95% confidence interval (CI) 1.40-23.07, p=0.015]. When analyzed by tertiles, relative odds of NRP were consistently increasing (OR1 for Q2 vs. Q1: 1.25, 95% CI: 0.27-5.73, p=0.770; OR2 for Q3 vs. Q1: 5.96, 95% CI: 1.33-26.66, p=0.02), despite multivariable adjustment. Receiver operating characteristic curve analysis demonstrated that the microRNA-660-5p level of 10.17 was the best cut-off level to predict the incidence of the NRP in patients undergoing PPCI with an area under the ROC curve (AUC) of 0.768 (95% CI: 0.636-0.890). CONCLUSION: Circulating miR-660-5p was significantly associated with NRP, and it may be a useful biomarker to predict the incidence of NRP in patients with STEMI undergoing PPCI.
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Jianwei Zhang (2020) conducted an observational in ST segment elevation myocardial infarction (STEMI) (n=52). High circulating miR-660-5p (third tertile) vs. Low circulating miR-660-5p (lower two tertiles) was evaluated on Angiographic no-reflow phenomenon (NRP) (OR 5.68, 95% CI 1.40-23.07, p=0.015). Patients with high circulating miR-660-5p levels had a nearly 6-fold higher risk of no-reflow phenomenon compared to those with low levels (OR 5.68, 95% CI 1.40-23.07, p=0.015).
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