The relationship between serum miR-126,miR-222,cardiac function,and major adverse cardiovascular events in patients with chronic heart failure complicated with atrial fibrillation

Wang Yuqiao; Zhao Yanli; Song Mengxian; Zhang Huan; He Hong; Wang Ying

doi:10.3969/j.issn.1671-6450.2024.01.003

Abstract：Objective To analyze the relationship between serummiR-126,miR-222,cardiac function,and major ad-verse cardiovascular events(MACE)in patients with chronic heart failure(CHF)and atrial fibrillation(AF).Methods 120 patients with CHF combined with AF admitted to the Cardiology Department of Lianyungang Hospital Affiliated to Xuzhou Medical University from January 2020 to October 2022 were selected as the AF group.According to the New York Heart Association(NYHA)cardiac function classification,they were divided into Grade I 22 cases,Grade Ⅱ 29 cases,Grade Ⅲ 26 cases,and Grade IV43 cases.Follow up for3 months and divide into MACEsubgroup and non-MACEsubgroup based on the occurrence of MACE.100 CHF patients without concomitant AF admitted during the same period were selected as the non-AF group.Another 80 healthy volunteers who underwent physical examinations in hospitals during the same period were selected as the healthy control group.Detect and compare the serum levels of miR-126 and miR-222 in three groups of CHF patients with AF and different NYHA heart function grades.Analyze the correlation between serum miR-126,miR-222 levels and NYHA cardiac function grading in patients with CHF combined with AF.Multivariate logistic regression analysis on the influencing factors of MACE in patients with CHF and AF.The predictive value of receiver operating characteristic(ROC)curve analysis of serum miR-126 and miR-222 levels for MACE in patients with CHF and AF.Results The levels of serum miR-126 and miR-222 in the AF group<non AF group<healthy control group(F/P=277.894/<0.001,410.653/<0.001).The levels of serum miR-126 and miR-222 in grades Ⅰ,Ⅱ,Ⅲ,and Ⅳ decreased sequentially(F/P=147.517/<0.001,115.625/<0.001).The serumlevels of miR-126 and miR-222 in patients with CHF combined with AF were negatively correla-ted with NYHA cardiac function grading(rs=-0.501 and-0.496,P<0.001).During a 3-month follow-up,the incidence of MACE in 120 patients with CHF and AF was 31.67%(38/120).NYHA heart function grades Ⅲ-Ⅳ and elevated N-terminal precursor B-type natriuretic peptide were independent risk factors for MACE in CHF and AF patients[OR(95%CI)=1.872(1.381-2.538),1.002(1.000-1.004)〛.Elevated serum miR-126 and miR-222 were independent protective factors[OR(95%CI)=0.679(0.535-0.862),0.531(0.379-0.743)].The AUC of serum miR-126,miR-222,and their combination in predicting MACE in CHF patients with AF were 0.734,0.741,and 0.839,respectively.The combination of the two was superior to their individual predictive efficacy(Z=4.235,4.136,P=0.013,0.014).Conclusion The decrease in serum miR-126 and miR-222 levels in patients with CHF combined with AF is related to decreased heart function and the occurrence of MACE.The combined detection of serum miR-126 and miR-222 levels has a high predictive power for MACE in patients with CHF com-bined with AF.