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Background <p>To investigate the early diagnostic value of circulating microRNA-1 for unstable angina (UA) in type 2 diabetes patients presenting with chest pain as the main symptom and without ST-T changes on electrocardiograms and to assess the predictive value of microRNA-1 for the need for a second coronary angiography (CAG) in these UA patients.</p> Methods <p>All hospitalized patients with chest pain undergoing first-time CAG demonstrated no ST-T changes on initial and pre-CAG electrocardiograms and normal initial high-sensitivity cardiac troponin I levels. Plasma microRNA-1 levels were measured via quantitative reverse transcription polymerase chain reaction within 3&#xa0;h of chest pain onset. UA patients were followed up for 5 years through phone calls and outpatient visits. The endpoints included second CAG and all-cause mortality.</p> Results <p>A total of 127 patients were enrolled, with 62 in the UA group and 65 in the non-UA group. MicroRNA-1, low-density lipoprotein cholesterol, and diabetes duration were significantly greater in the UA group than in the non-UA group. The area under the receiver operating characteristic curve for microRNA-1 in diagnosing UA was 0.811. Binary logistic regression analysis indicated that microRNA-1 and low-density lipoprotein cholesterol were predictive factors for UA. No UA patients were lost to follow-up or died during the follow-up period. Patients who underwent a second CAG had significantly higher microRNA-1 levels than those who did not. Binary logistic regression revealed that microRNA-1 and hemoglobin a1c were predictive factors for second CAG in UA patients during follow-up. Cox regression analysis revealed that microRNA-1 was an independent risk factor for a second CAG during follow-up in UA patients. Using the Youden index, the optimal cut-off value of microRNA-1 (2<sup>−ΔΔCt</sup>) for UA diagnosis was determined to be 1.510, which stratified UA patients into high- and low-expression groups. Kaplan-Meier survival analysis revealed that the microRNA-1 high-expression group had a significantly greater proportion of second CAG than did the microRNA-1 low-expression group.</p> Conclusions <p>For type 2 diabetes patients with acute chest pain, no ST-T changes on electrocardiograms, and negative high-sensitivity cardiac troponin I, microRNA-1 may offer early diagnostic value for UA and could serve as an independent risk factor for the need for a second CAG within 5 years.</p>

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Circulating MicroRNA-1 for the early prediction of unstable angina and the value of second coronary angiography in type 2 diabetes patients with chest pain and no ST-T changes on electrocardiograms

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年5月28日

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  • Xiaopu Zhang,
  • Qiang Wang,
  • Can Hou,
  • Jin Zhu,
  • Ling Yang,
  • Tong Su

摘要

Background

To investigate the early diagnostic value of circulating microRNA-1 for unstable angina (UA) in type 2 diabetes patients presenting with chest pain as the main symptom and without ST-T changes on electrocardiograms and to assess the predictive value of microRNA-1 for the need for a second coronary angiography (CAG) in these UA patients.

Methods

All hospitalized patients with chest pain undergoing first-time CAG demonstrated no ST-T changes on initial and pre-CAG electrocardiograms and normal initial high-sensitivity cardiac troponin I levels. Plasma microRNA-1 levels were measured via quantitative reverse transcription polymerase chain reaction within 3 h of chest pain onset. UA patients were followed up for 5 years through phone calls and outpatient visits. The endpoints included second CAG and all-cause mortality.

Results

A total of 127 patients were enrolled, with 62 in the UA group and 65 in the non-UA group. MicroRNA-1, low-density lipoprotein cholesterol, and diabetes duration were significantly greater in the UA group than in the non-UA group. The area under the receiver operating characteristic curve for microRNA-1 in diagnosing UA was 0.811. Binary logistic regression analysis indicated that microRNA-1 and low-density lipoprotein cholesterol were predictive factors for UA. No UA patients were lost to follow-up or died during the follow-up period. Patients who underwent a second CAG had significantly higher microRNA-1 levels than those who did not. Binary logistic regression revealed that microRNA-1 and hemoglobin a1c were predictive factors for second CAG in UA patients during follow-up. Cox regression analysis revealed that microRNA-1 was an independent risk factor for a second CAG during follow-up in UA patients. Using the Youden index, the optimal cut-off value of microRNA-1 (2−ΔΔCt) for UA diagnosis was determined to be 1.510, which stratified UA patients into high- and low-expression groups. Kaplan-Meier survival analysis revealed that the microRNA-1 high-expression group had a significantly greater proportion of second CAG than did the microRNA-1 low-expression group.

Conclusions

For type 2 diabetes patients with acute chest pain, no ST-T changes on electrocardiograms, and negative high-sensitivity cardiac troponin I, microRNA-1 may offer early diagnostic value for UA and could serve as an independent risk factor for the need for a second CAG within 5 years.