Prognostic value of peripheral blood circular RNAs in patients with acute coronary syndrome

BACKGROUND: Acute coronary syndrome (ACS) is a clinical emergency. Although its prognosis has been significantly improved, some patients will have major adverse cardiovascular events (MACE) in the short term. We aimed to analyze the prognostic value of circRNAs in patients with ACS. METHODS: This diagnostic accuracy study enrolled a total of 100 patients with ACS from January 2019 to January 2021. All patients were followed up for 30 days. The expression of circRNAs in peripheral blood was determined using real-time fluorescence quantification PCR (qRT-PCR). 30 patients with MACE were divided into the observation group and 70 patients without MACE were divided into the control group. The general data and the detection results of circRNAs of the two groups were compared, and the influencing factors of MACE in ACS patients were analyzed by logistic regression. Receiver operating characteristic (ROC) curves were generated, and the predictive value of peripheral blood circRNAs for MACE in patients with ACS was evaluated. RESULTS: The age, sex, hypertension, dyslipidemia, location of coronary artery disease, left ventricular ejection fraction, and Killip grade were not significantly different between the two groups (P>0.05). Type 2 diabetes and smoking history in the observation group were also comparable between the two groups (P>0.05). Logistic regression analysis showed that type 2 diabetes mellitus [odd ratio (OR) 1.314, 95% confidence interval (CI): 1.052–1.437, P=0.002], smoking history (OR 1.227, 95% CI: 1.014–1.385, P=0.001), and the up-regulation of circRNAs in peripheral blood (OR 1.312, 95% CI: 1.028–1.452, P=0.002) were risk factors for MACE in ACS patients. The results of the ROC curve showed that peripheral blood circRNAs could be used as a predictor of MACE in patients with ACS. The best cut-off value was 96.44 ng/µL, the diagnostic sensitivity was 75.71%, the specificity was 100%, and the area under the curve (AUC) was 0.931 (95% CI: 0.884–0.977, P<0.001). CONCLUSIONS: Peripheral blood circRNAs are up-regulated about 3 fold in the peripheral blood of patients with ACS. Abnormal expression is an independent risk factor affecting MACE. Peripheral blood circRNAs can assist in clinical decision-making processes in patients with ACS.