ABSTRACT
BACKGROUND The aims of this study were to examine the expression of miRNA-21 in the serum of elderly patients (>65 years) with acute myocardial infarction (AMI) and to investigate the potential role of serum miRNA-21 as a marker of early cardiac myocyte damage. MATERIAL AND METHODS Thirty-eight elderly patients with recent AMI, 27 elderly patients with unstable angina pectoris, and 25 healthy elderly individuals were included in the study. Serum miRNA-21 expression was determined following total RNA extraction and reverse-transcribed into cDNA, followed by reverse transcription-polymerase chain reaction (RT-PCR). Serum creatine kinase MB isoenzyme (CK-MB) and cardiac troponin I (cTnI) levels were analyzed by electrochemiluminescence. Apoptosis of human cardiac myocytes (HCM) was analyzed using fluorescence-activated cell sorting (FACS), and protein expression of caspase-3 was detected using Western blot. RESULTS Expression levels of miRNA-21 in the serum of elderly patients with AMI were positively correlated with serum levels of CK-MB (r=0.3683, P=0.0229) and cTnI (r=0.5128, P=0.009). Following tumor necrosis factor (TNF)-α induction, the apoptosis rates of HCM transfected with the miRNA-21 mimic short hairpin RNA (shRNA) were downregulated by 39.1% compared with control HCM cells, and protein expression of c-Jun N-terminal kinases (JNK) and p38 were unchanged (P>0.05); protein expression of p-JNK, p-p38 and caspase-3 were downregulated by 37.1%, 35.8%, and 36.0%, respectively. CONCLUSIONS Expression of miRNA-21 was upregulated in the serum of elderly patients with AMI, which inhibited TNF-a induced apoptosis in HCM by activating the JNK/p38/caspase-3 signaling pathway.
Subject(s)
MicroRNAs/blood , Myocardial Infarction/genetics , Aged , Aged, 80 and over , Apoptosis/genetics , Biomarkers/blood , Caspase 3/metabolism , Cell Line , Creatine Kinase, MB Form/blood , Creatine Kinase, MB Form/genetics , Female , Humans , MAP Kinase Signaling System/physiology , Male , MicroRNAs/biosynthesis , MicroRNAs/genetics , Myocardial Infarction/blood , Myocardial Infarction/pathology , Myocardium/metabolism , Myocardium/pathology , Myocytes, Cardiac/metabolism , Myocytes, Cardiac/pathology , Troponin I/blood , Troponin I/genetics , Tumor Necrosis Factor-alpha/metabolismABSTRACT
OBJECTIVES: To study the efficacy of percutaneous thrombectomy (PT) in improving myocardial microcirculation in elderly acute myocardial infarction (AMI) patients. METHODS: A total of 104 patients (> or = 65 years) with AMI and coronary thrombus shown by angiography were randomly divided into a group of percutaneous coronary intervention (PCI) (n=52) and a group of PCI plus PT (n=52). At 24 h and 1 week after PCI, real-time myocardial contrast echocardiography was performed by contrast pulse sequencing technology. Contrast score index, contrast defect length/left ventricle length [CDL/LVL (%)], wall motion score index and wall motion abnormal length/LVL (%) were calculated. RESULTS: At each time point, in patients treated with PCI plus PT, contrast score index, CDL/LVL (%), wall motion score index and wall motion abnormal length/LVL (%) were significantly lower than that in the PCI group. CONCLUSION: Thrombectomy reduces the noreflow and the extent of microvascular obstruction, thus it was a feasible therapy in elderly patients with AMI.
Subject(s)
Angioplasty, Balloon, Coronary , Coronary Circulation , Coronary Thrombosis/therapy , Echocardiography, Doppler, Color , Microcirculation , Myocardial Infarction/therapy , No-Reflow Phenomenon/prevention & control , Thrombectomy , Age Factors , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary/adverse effects , Contrast Media , Coronary Angiography , Coronary Thrombosis/diagnostic imaging , Coronary Thrombosis/physiopathology , Feasibility Studies , Female , Humans , Male , Myocardial Infarction/diagnostic imaging , Myocardial Infarction/physiopathology , No-Reflow Phenomenon/diagnostic imaging , No-Reflow Phenomenon/etiology , No-Reflow Phenomenon/physiopathology , Thrombectomy/adverse effects , Time Factors , Treatment Outcome , Ventricular Function, LeftABSTRACT
OBJECTIVE: To evaluate the prognostic significance of hyponatremia in patients with AMI. METHODS: The study population consisted of 670 patients with AMI in coronary care unit in our hospital from January 2003 to December 2004. The patients were designed into three groups according to serum sodium concentration within twenty four to forty eight hours following the onset of AMI: Group A. Na(+) > or = 135 mmol/L; Group B. Na(+) 120-135 mmol/L; Group C. Na(+) < or = 120 mmol/L. The data of myocardial enzymes, myocardial infarction size, heart function and inhospital mortality were analyzed retrospectively. RESULTS: 1. The inhospital mortality of each group: group A was 7.6% (17/225), group B was 8.1% (34/421), group C was 33.3% (8/24). The difference between group C and group B or group A was significant. The P value was little than 0.05. 2. Activities of serum creatine phosphatase kinase and serum creatine phosphatase kinase isoenzymes and myocardial infarction sizes in each group were different (P < 0.05). 3. 59 cases of all died and 611 cases of all recovered in duration of hospital stay. Serum sodium concentrations of the recovered group were (133.00 +/- 5.25) mmol/L, and that of the died group were (122.00 +/- 7.25) mmol/L (P < 0.01). 4. In a multivariate logistic regression analysis, hyponatremia was associated with 30-day mortality in patients with AMI. In analysis of the association between the degree of hyponatremia and outcome, we observed that the risk of 30-day mortality increased with the severity of hyponatremia. CONCLUSION: Hyponatremia may be one of the important markers that predict a worse prognosis in patients with AMI.
