ObjectiveOur recently published study discovers that exosomal microRNA (miR)-186-5p promotes vascular smooth muscle cell viability and invasion to facilitate atherosclerosis. This research aimed to explore the prognostic implication of serum exosomal miR-186-5p in acute myocardial infarction (AMI) patients receiving percutaneous coronary intervention (PCI).MethodsOne hundred and fifty AMI patients receiving PCI and 50 healthy controls (HCs) were screened. Serum exosomal miR-186-5p was detected by reverse transcriptase-quantitative polymerase chain reaction assay in AMI patients at admission and after PCI, as well as in HCs after enrollment. Major adverse cardiac events (MACE) were recorded during follow-up in AMI patients receiving PCI.ResultsSerum exosomal miR-186-5p was raised in AMI patients vs. HCs (P < 0.001). Besides, serum exosomal miR-186-5p was positively linked to body mass index (P = 0.048), serum creatinine (P = 0.021), total cholesterol (P = 0.029), and C-reactive protein (P = 0.018); while it was reversely linked with estimated glomerular filtration rate (P = 0.023) in AMI patients. Interestingly, serum exosomal miR-186-5p was correlated with the diagnosis of ST-segment elevation myocardial infarction (P = 0.034). Notably, serum exosomal miR-186-5p was decreased after PCI vs. at admission (P < 0.001). The 6-, 12-, 18-, and 24-month accumulating MACE rates were 4.5%, 8.9%, 14.8%, and 14.8% in AMI patients. Furthermore, serum exosomal miR-186-5p ≥3.39 (maximum value in HCs) after PCI (P = 0.021) and its decrement percentage <median (35%) decrement (P = 0.044) estimated elevated MACE in AMI patients.ConclusionSerum exosomal miR-186-5p is reduced after PCI, and its post-PCI high level or minor decrease estimates increased MACE risk in AMI patients.

中文翻译：

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血清外泌体miR-186-5p的纵向变化评估接受经皮冠状动脉介入治疗的急性心肌梗死患者的主要不良心脏事件

目的我们最近发表的研究发现，外泌体微小RNA（miR）-186-5p可促进血管平滑肌细胞的活力和侵袭，从而促进动脉粥样硬化。本研究旨在探讨血清外泌体miR-186-5p对接受经皮冠状动脉介入治疗（PCI）的急性心肌梗死（AMI）患者的预后意义。方法筛选150名接受PCI的AMI患者和50名健康对照（HC）。在 AMI 患者入院时和 PCI 后以及入组后的 HC 中通过逆转录酶定量聚合酶链反应测定检测血清外泌体 miR-186-5p。接受 PCI 的 AMI 患者在随访期间记录了主要不良心脏事件 (MACE)。 结果 AMI 患者与 HC 患者相比，血清外泌体 miR-186-5p 升高（磷< 0.001）。此外，血清外泌体 miR-186-5p 与体重指数呈正相关（磷= 0.048), 血清肌酐 (磷= 0.021), 总胆固醇 (磷= 0.029) 和 C 反应蛋白 (磷= 0.018);而它与估计的肾小球滤过率呈反向相关（磷= 0.023）在 AMI 患者中。有趣的是，血清外泌体 miR-186-5p 与 ST 段抬高型心肌梗死的诊断相关（磷= 0.034）。值得注意的是，与入院时相比，PCI 后血清外泌体 miR-186-5p 降低（磷< 0.001）。 AMI 患者 6、12、18 和 24 个月累积 MACE 发生率分别为 4.5%、8.9%、14.8% 和 14.8%。此外，PCI 后血清外泌体 miR-186-5p ≥3.39（HC 中的最大值）（磷= 0.021) 且其递减百分比＜中位数 (35%) 递减 (磷= 0.044) 估计 AMI 患者的 MACE 升高。结论 PCI 后血清外泌体 miR-186-5p 降低，PCI 后其高水平或轻微降低估计 AMI 患者的 MACE 风险增加。