Low miR‐19b‐1‐5p Expression Is Related to Aspirin Resistance and Major Adverse Cardio‐ Cerebrovascular Events in Patients With Acute Coronary Syndrome

医学 阿司匹林 急性冠脉综合征 危险系数 内科学 血小板活化 心脏病学 生物标志物 心肌梗塞 血小板 置信区间 生物化学 化学
作者
Sandeep Singh,Maurice W J de Ronde,Esther E. Creemers,Ingeborg van der Made,Roelien A. M. Meijering,Mark Y. Chan,Sock Hwee Tan,Chee Tang Chin,A. Richards,Richard W. Troughton,Alan Yean Yip Fong,Bryan P. Yan,Sara-Joan Pinto-Sietsma
出处
期刊:Journal of the American Heart Association [Wiley]
卷期号:10 (2) 被引量:8
标识
DOI:10.1161/jaha.120.017120
摘要

Background Because of a nonresponse to aspirin (aspirin resistance), patients with acute coronary syndrome (ACS) are at increased risk of developing recurrent event. The in vitro platelet function tests have potential limitations, making them unsuitable for the detection of aspirin resistance. We investigated whether miR-19b-1-5p could be utilized as a biomarker for aspirin resistance and future major adverse cardio-cerebrovascular (MACCE) events in patients with ACS. Methods and Results In this cohort study, patients with ACS were enrolled from multiple tertiary hospitals in Christchurch, Hong Kong, Sarawak, and Singapore between 2011 and 2015. MiR-19b-1-5p expression was measured from buffy coat of patients with ACS (n=945) by reverse transcription quantitative polymerase chain reaction. Platelet function was determined by Multiplate aggregometry testing. MACCE was collected over a mean follow-up time of 1.01±0.43 years. Low miR-19b-1-5p expression was found to be related to aspirin resistance as could be observed from sustained platelet aggregation in the presence of aspirin (-Log-miR-19b-1-5p, [unstandardized beta, 44.50; 95% CI, 2.20-86.80; P<0.05]), even after adjusting for age, sex, ethnicity, and prior history of stroke. Lower miR-19b-1-5p expression was independently associated with a higher risk of MACCE (-Log-miR-19b-1-5p, [hazard ratio, 1.85; 95% CI, 1.23-2.80; P<0.05]). Furthermore, a significant interaction was noted between the inverse miR-19b-1-5p expression and family history of premature coronary artery disease (P=0.01) on the risk of MACCE. Conclusions Lower miR-19b-1-5p expression was found to be associated with sustained platelet aggregation on aspirin, and a higher risk of MACCE in patients with ACS. Therefore, miR-19b-1-5p could be a suitable marker for aspirin resistance and might predict recurrence of MACCE in patients with ACS.
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