The Value of Dynamic Electrocardiogram and Serum miR-145 and NT-proBNP in Diagnosis and Prognosis of Coronary Heart Disease

XU Shuyan; XU Zhiwei; ZHAO Aihong; YUAN Qiong

doi:10.12102/j.issn.1672-1349.2025.01.018

Abstract：Objective: To explore the application value of dynamic electrocardiogram indices and serum microRNA-145 (miR-145) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in the diagnosis and prognosis evaluation of coronary heart disease. Methods: A prospective study was conducted, selecting 120 patients highly suspected of coronary heart disease admitted to our hospital between April 2020 and April 2022 as the study subjects. All patients underwent coronary angiography, and the results were used as the gold standard. Patients diagnosed with coronary heart disease were included in the coronary heart disease group, while those without coronary heart disease were included in the non-coronary heart disease group. Patients with coronary heart disease received PCI treatment, and were followed up for 12 months. According to the occurrence of major adverse cardiovascular events (MACE) during follow-up, they were divided into the poor prognosis group and the good prognosis group. Baseline data and dynamic electrocardiogram indices of the two groups were statistically compared. The receiver operating characteristic (ROC) curve was used to evaluate the diagnostic and prognostic value of dynamic electrocardiogram indices and serum levels of miR-145 and NT-proBNP. Results: After coronary angiography, 83 patients (69.17%) were confirmed to have coronary heart disease. Compared with the non-coronary heart disease group, the coronary heart disease group had lower levels of dynamic electrocardiogram indices including SDNN (standard deviation of NN intervals), SDANN (standard deviation of the mean of NN intervals every 5 minutes over 24 hours), SDNNI (average of standard deviations of normal RR intervals every 5 minutes within 24 hours), and lower serum miR-145 levels, but higher serum NT-proBNP levels (P < 0.05). ROC curve results showed that the area under the curve (AUC) for diagnosing coronary heart disease by SDNN, SDANN, SDNNI, miR-145, NT-proBNP, and combined detection were all above 0.70, indicating certain predictive value, with the highest AUC for combined detection. After 12 months of follow-up, 21 patients (25.30%) had poor prognosis. The proportion of patients with hyperlipidemia was higher in the poor prognosis group compared to the good prognosis group. SDNN, SDANN, SDNNI, and miR-145 levels were lower, while serum NT-proBNP levels were higher in the poor prognosis group compared to the good prognosis group (P < 0.05). ROC curve results showed that the AUC for predicting poor prognosis after PCI in patients with coronary heart disease by SDNN, SDANN, SDNNI, miR-145, NT-proBNP, and combined detection were all above 0.70, indicating certain predictive value, with the highest AUC for combined detection. Conclusion: Dynamic electrocardiogram indices and serum levels of NT-proBNP and miR-145 can effectively diagnose coronary heart disease and are closely related to poor prognosis in patients with coronary heart disease, thereby effectively predicting the risk of poor prognosis.