Application value of dynamic electrocardiogram combined with serum HDAC4 and miR-139-5p in the diagnosis and prognosis evaluation of acute myocardial infarction

LI Yang; LIU Juan; PAN Jing; TANG Shuang-rong

doi:10.3969/j.issn.1672-5301.2024.03.014

Abstract：Objective To explore the application value of dynamic electrocardiogram(DCG)combined with serum histone deacetylase 4(HDAC4)and microRNA-139-5p(miR-139-5p)in the diagnosis and prognosis evaluation of acute myocardial infarction(AMI).Methods:From January 2021 to January 2023,102 AMI patients accepted by Hengshui People's Hospital were collected.They were grouped into a good group of 66 cases and an poor group of 36 cases based on whether cardiovascular adverse events(MACE)occurred within 6 months after discharge;another 70 healthy examinees were regarded as the control group.All study subjects underwent DCG examination;enzyme-linked immunosorbent assay was applied to detect serum HDAC4 level,qRT-PCR method was applied to detect the expression of miR-139-5p in serum.ROC curve was applied to predict the diagnostic value of serum HDAC4,miR-139-5p,and DCG combined with serum HDAC4,miR-139-5p for AMI and prognosis;four table method was applied to analyze the diagnostic value of DCG for AMI and prognosis.Results The serum HDAC4 level in AMI patients was obviously lower than that in healthy individuals,and the miR-139-5p level was obviously higher than that in healthy individuals(P<0.05).The serum HDAC4 level in the good group was higher than that in the poor group,and the miR-139-5p level was lower than that in the poor group(P<0.05).The AUC of HDAC4 in diagnosing AMI was 0.789,with a sensitivity of 63.73%and a specificity of 82.86%;the AUC of miR-139-5p in diagnosing AMI was 0.791,with a sensitivity of 73.53%and a specificity of 81.43%;the AUC of DCG in diagnosing AMI was 0.782,with a sensitivity of 73.53%and a specificity of 82.86%.The AUC of DCG combined with serum HDAC4 and miR-139-5p levels for diagnosing AMI was 0.916,which was obviously higher than that of single detection(ZHDAC4-combination=3.735,P<0.001,ZmiR-139-5p-combination=3.467,P<0.001;ZDCG-combination= 4.444,P<0.001).The AUC of HDAC4 in diagnosing AMI patients was 0.898,with a sensitivity of 80.56%and a specificity of 86.36%;the AUC of miR-139-5p in diagnosing the prognosis of AMI patients was 0.857,the sensitivity was 77.78%,and the specificity was 80.30%;the AUC of DCG in diagnosing the prognosis of AMI patients was 0.790,the sensitivity was 77.78%,and the specificity was 80.30%;the AUC of DCG combined with serum HDAC4 and miR-139-5p levels in diagnosing the prognosis of AMI patients was 0.931,which was obviously higher than that of single detection(ZHDAC4-combination=2.005,P=0.045,ZmiR-139-5p-combination=2.707,P=0.007;ZDCG-combination=3.969,P<0.001).Conclusion The combination of DCG and serum HDAC4 and miR-139-5p levels has important application value in the diagnosis and prognosis evaluation of AMI.