Exosomal circ-0020887 and circ-0009590 as novel biomarkers for the diagnosis and prediction of short-term adverse cardiovascular outcomes in STEMI patients

Figures

• 

  Figure 1. Identification and characterization 4 DEECs in patients with myocardial infarction from GEO database. (a) The microarray dataset (GSE160717 and GSE197137) and the RNA-Seq dataset (GSE208194) were downloaded for integrated analyses of DEECs, and venn diagram showed the intersection of DEECs. (b–e) The genomic loci and splicing schematic diagram of exo-circ-0001490, exo-circ-0020887, exo-circ-0009590, and exo-circ-0055440. (f) The stability of exo-circ-0001490, exo-circ-0020887, exo-circ-0009590, exo-circ-0055440, KIF2A, NUP98, RERE, and USP39 mRNA was detected by RNase R degradation assay. DEECs: differentially expressed exosomal circRNAs; KIF2A: kinesin heavy chain member 2A; NUP98: nucleoporin 98 and 96 precursor; RERE: arginine-glutamic acid dipeptide repeats; USP39: ubiquitin-specific peptidase 39; RNase R: Ribonuclease R. Data were expressed as mean ± standard deviation from three independent experiments. ns P > 0.05, ***P < 0.001.

• 

  Figure 2. Upregulated expression of exo-circ-0020887 and exo-circ-0009590 in plasma from STEMI patients. (a and b) qRT-PCR analysis of exo-circ-0001490 and exo-circ-0055440 expression levels (normalized to GAPDH) in plasma from 64 STEMI patients and 64 healthy controls. (c and d) The expression levels of plasma exo-circ-0020887 and exo-circ-0009590 were increased in STEMI patients that in plasma of healthy controls. STEMI: ST-segment elevation myocardial infarction; qRT-PCR: quantitative real-time PCR. Data were expressed as mean ± standard deviation from three independent experiments. ns P > 0.05, ***P < 0.001.

• 

  Figure 3. Diagnostic efficacy of plasma exo-circ-0020887 and exo-circ-0009590 in STEMI patients. (a) ROC curves analysis of exo-circ-0020887, cTnI, and CK-MB for differentiating STEMI patients from healthy controls. (b) ROC curves analysis showed that the diagnostic power of exo-circ-0009590 for STEMI exceeded cTnI and CK-MB. (c) The exo-circ-0020887 and exo-circ-0009590 in combination with cTnI and CK-MB had the highest diagnostic accuracy. ROC: receiver operating characteristic; cTnI: cardiac troponin I; CK-MB: creatine kinase isoenzymes.

• 

  Figure 4. Prognostic value of plasma exo-circ-0020887 and exo-circ-0009590 in STEMI patients. (a) Kaplan–Meier survival curves analysis of the MACE-free 1-year survival rate in STEMI patients based on exo-circ-0020887 expression status. (b) The MACE-free 1-year survival rate was lower in STEMI patients with high exo-circ-0009590 expression than those patients with low exo-circ-0009590 expression. MACE: major adverse cardiovascular events.

• 

  Figure A1. Correlations between the MACE-free 1-year survival rate and LDL-C, hs-CRP, LP(a), cTnI and CK-MB expression in STEMI patients. (a–e) Kaplan-Meier survival curves analysis of the MACE-free 1-year survival rate in STEMI patients based on the levels of LDL-C, hs-CRP, LP(a), cTnI and CK-MB. MACE: major adverse cardiovascular events; LDL-C: low density lipoprotein cholesterol; hs-CRP: high sensitivity C-reactive protein; LP(a): lipoprotein a; cTnI: cardiac troponin I; CK-MB: creatine kinase isoenzymes.