血清miR-3646、miR-34a水平对高血压伴慢性心力衰竭患者发生主要不良心血管事件的预测价值OA

Objective To explore the predictive value of serum microRNA-3646(miR-3646)and microRNA-34a(miR-34a)levels for major adverse cardiovascular events(MACE)in patients with hypertension and concomitant chronic heart failure(CHF).Methods A total of 100 hypertensive patients with CHF diagnosed and treated in the Clinical Laboratory of Qinghai Provincial Hospital of Traditional Chinese Medicine from April 2019 to April 2024 were selected as the study group.They were divided into the MACE subgroup(n=36)and the non-MACE subgroup(n=64)based on whether MACE occurred within 1 year after treatment.In addition,73 healthy physical examinees from the same hospital during the same period were selected as the control group.The qRT-PCR method was used to detect serum levels of miR-3646 and miR-34a.Multivariate logistic regression was used to analyze factors influencing the occurrence of MACE.Relative risk analysis was performed to evaluate the effect of different serum levels of miR-3646 and miR-34a on the occurrence of MACE in hypertensive patients with CHF.ROC curve analysis was used to assess the predictive value of serum miR-3646 and miR-34a for MACE in these patients.Results The study group had significantly higher serum levels of miR-3646 and miR-34a than the control group(t=12.615,12.480,both P＜0.001).During a one-year follow-up period,36 out of 100 hypertensive patients with CHF devel-oped MACE,with an incidence rate of 36.00％.Among them,there were 12 cases of angina pectoris,4 cases of stroke,5 ca-ses of non-fatal myocardial infarction,2 cases of cardiogenic death,and 13 cases of acute heart failure.In the MACE sub-group,the proportion of patients with NYHA class Ⅲ-Ⅳ,as well as the serum levels of miR-3646 and miR-34a,were higher than those in the non-MACE subgroup,while the LVEF level was lower(Z/t=2.678,8.228,7.727,5.074;P=0.007,＜0.001,＜0.001,＜0.001).Elevated serum levels of miR-3646 and miR-34a were both risk factors for MACE[OR(95％CI)=3.149(1.770-5.603),2.948(1.571-5.531)].The risk of MACE in patients with high serum levels of miR-3646 and miR-34a was 2.162 times and 2.082 times higher,respectively,than in patients with low levels.The AUC values of serum miR-3646,miR-34a,and their combination for predicting MACE in hypertensive patients with CHF were 0.840,0.841,and 0.962,respec-tively.The combined predictive value was superior to that of miR-3646 or miR-34a alone(Z=3.125,3.292;P=0.002,0.001).Conclusion In hypertensive patients with CHF,the serum levels of miR-3646 and miR-34a are elevated.The combined de-tection of these two biomarkers has higher predictive efficacy for MACE occurrence in these patients.