The Relationship between Serum miR-140-3p,SDC-4 Levels and the Occurrence of Malignant Arrhythmias in Patients with ST-segment Elevation Myocardial Infarction after Interventional Treatment

DAI Zhigao; WANG Yanxin; XU Yingli; YANG Penghui

doi:10.12102/j.issn.1672-1349.2026.01.015

Abstract：Objective: To explore the relationship between serum microRNA-140-3p (miR-140-3p) and syndecan-4 (SDC-4) levels and the occurrence of malignant arrhythmia (MA) after percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 142 patients with STEMI who were treated at Qinhuangdao Hospital of Integrated Traditional Chinese and Western Medicine from October 2021 to October 2023 were selected as the STEMI group. Another 74 individuals who underwent health check-ups during the same period were selected as the control group. According to whether MA occurred, the patients were divided into the MA group (26 cases) and the non-MA group (116 cases). The serum SDC-4 levels were detected using enzyme-linked immunosorbent assay (ELISA), and the expression levels of serum miR-140-3p were detected by real-time fluorescent quantitative polymerase chain reaction (qRT-PCR). Target Scan Human was used to predict the targeting relationship between miR-140-3p and SDC-4. Pearson correlation analysis was performed to evaluate the correlation between serum miR-140-3p and SDC-4 expression levels and laboratory serum indicators. Receiver operating characteristic (ROC) curves were plotted to assess the predictive value of miR-140-3p and SDC-4 for the occurrence of MA after PCI in patients with STEMI. Results: Compared with the control group, the serum miR-140-3p expression level was significantly decreased, and the SDC-4 level was significantly increased in the STEMI group (P < 0.05). There were significant differences in Killip classification, creatine kinase isoenzyme (CK-MB), troponin I (cTnI), myoglobin (Mb), tumor necrosis factor α (TNF-α), interleukin (IL)-6, IL-1β, and brain natriuretic peptide (BNP) levels between the MA group and the non-MA group (P < 0.05). Compared with the non-MA group, the serum miR-140-3p expression level was significantly decreased, and the SDC-4 level was significantly increased in the MA group (P < 0.05). Correlation analysis showed that miR-140-3p was negatively correlated with CK-MB, cTnI, Mb, IL-6, TNF-α, and IL-1β (P < 0.05), while SDC-4 was positively correlated with these indicators (P < 0.05). Target Scan Human prediction results showed that there was a targeting binding site between miR-140-3p and SDC-4, and the serum levels of miR-140-3p and SDC-4 in STEMI patients were negatively correlated (r = -0.369, P < 0.001). The area under the curve (AUC) for predicting MA after PCI using miR-140-3p and SDC-4 alone and in combination were 0.893, 0.846, and 0.961, respectively. The combined prediction was better than individual prediction (Z for miR-140-3p combined = 2.321, P = 0.020; Z for SDC-4 combined = 2.340, P = 0.019). Conclusion: The serum expression levels of miR-140-3p and SDC-4 are closely related to the occurrence of MA after PCI in patients with STEMI, and their combined monitoring has a high predictive value for MA.