Correlation Between Serum PCSK9,miR-133a and Slow/No Reflow After PCI in Patients with Acute Coronary Syndrome
ZHANG Xuebing
LIU Jiangfeng
DU Qiubo
LI Xueqing
LIU Yuanyuan
Abstract：Objective To investigate the relationship between serum preprotein converting subtilisin kexin type 9(PCSK9),microRNA-133a(miR-133a)and slow/no reflow after direct percutaneous coronary intervention(PCI)in patients with acute coronary syndrome(ACS).Methods A total of 156 patients with ACS who underwent PCI in Fuwai Central China Cardiovascular Hospital from January 2021 to January 2023 were selected as research objects.According to blood flow classification after thrombus therapy(TIMI),the patients were divided into slow/no reflow group(study group,40 cases)and normal blood flow group(control group,116 cases).The differences of preoperative serum PCSK9,miR-133 a and other indexes between the two groups were compared,and the relationship between PCSK9,miR-133a and no reflux-free patients after PCI was analyzed.Results Group of patients with serum PCSK9,miR-133a,the number of lesion blood vessel,the number of coronary stenting was higher than the control group(P＜0.05).There were no significant differences in age,gender,past medical history,lesion blood vessel parts,such as myocardial injury index between the two groups(P＞0.05).Logistic multivariate regression analysis showed that preoperative serum PCSK9(OR=1.802,95％CI:1.538-2.112,P=0.006)and miR-133a(OR=2.132,95％CI:1.742-2.609,P=0.002)were independent risk factors for ACS patients with slow/no reflow after PCI.The area under receiver operating characteristic(ROC)curve of PCSK9 and miR-133a to predict slow/no reflow refluxation after PCI in ACS patients were 0.808 and 0.784,respectively,and the optimal predictive value were 76.54 μg·L-1 and 3.98 μg·L-1,respectively.The area under ROC curve of the combined detection of PCSK9 and miR-133a was increased to 0.839,higher than that of PCSK9(Z=4.155,P＜0.05),miR-133a(Z=3.754,P＜0.05)any single parameter,sensitivity and speciality rate were 80.60％and 81.66％respectively(P＜0.001).Conclusion PCSK9 and miR-133a have high predictive value for the occurrence of slow/no reflow phenomenon in ACS patients after PCI,which is helpful for early identification of slow/no reflow phenomenon.
Keywords：acute coronary syndromeslow/no reflowpreprotein converting subtilisin kexin type 9microRNA-133a
Publication Date：2025-03-13
Online Publishing Date：2026-09-12(First online date of this platform, not the publication date of the document)
Pages：6( 810-815 )