Effect of remote ischemic preconditioning on plasma miRNA-21 in patients with coronary heart disease

Objective To explore the effect of remote ischemic preconditioning(RIPC)on plasma miRNA-21 in patients with coronary heart disease(CHD), and further elaborate the mechanism of ischemic preconditioning and its clinical value. Methods A total of 165 patients with CHD patients who were hospitalized in Yuebei people's hospital from June 2015 to February 2017 were selected as the study subjects.All patients underwent elective percutaneous coronary intervention(PCI)and were randomly divided into 80 cases of control group and 85 cases of experimental group.In the second day after admission, the experimental group began to conduct RIPC twice every day for 3 days, and then the PCI was performed on the 5th day.The control group performed PCI on the 5th day after admission without RIPC.The plasma miR-21 was detected on the 2nd and 5th mornings after admission.cTn T was detected on the morning of the operation and 12h after PCI.The operation situation, laboratory test results and all cardiac events within 6 months were recorded. Results No difference in miR-21 level was found in 2nd day after admission between both groups(50.82±9.15 vs. 51.10±9.56, P>0.05), while there was significantly difference in 5th days(86.25±12.24 vs. 60.52±10.29, t=3.216, P<0.01). The plasma miR-21 levels in the experimental group were significantly higher than before(t=4.113, P<0.01), while there was no significant change in control group; The hs-cTnT was lower [(25.27±21.88)pg/ml vs.(38.79±32.46)pg/ml, t=2.162, P=0.01]and the rate of TIMI 3 blood flow was higher(92.9% vs. 85.0%, P=0.04)in RIPC group than control group; There were 6 patients with MACE in the experimental group, while 9 patients in the control group showed MACE, and the difference was not statistically significant.But baseline plasma miR-21 levels in all MACE patients were significantly lower than those of non-MACE patients(46.73±10.03 vs. 52.12±11.26, t=1.624, P=0.04); Multi Logistic regression analysis of risk factors that affect prognosis, found that the baseline of miR- 21, heart ejection fraction, cardiac function NYHA classification, number of lesion coronary artery is independent risk factors for CHD patients with PCI. Conclusions The RIPC can up-regulate the plasma miR-21 level and reduce the degree of reperfusion injury in patients with CHD.Moreover, plasma mirna-21 may be an important marker for evaluating the prognosis of patients with coronary heart disease. Key words: Coronary heart disease; Ischemic preconditioning; MicroRNA-21