Abstract：
BACKGROUND: Long noncoding RNAs (lncRNAs) have emerged as promising diagnostic biomarkers. Here, we investigated the cardiac-expressed and plasma-detectable lncRNA PDE4DIPP6 as a biomarker for non-ST-segment elevation myocardial infarction (NSTEMI), specifically assessing its potential to enhance the diagnostic efficacy of high-sensitivity cardiac troponin (hs-cTnT).
RESULTS: The study enrolled individuals presenting with suspected acute coronary syndrome (ACS). LncRNA quantification was performed in plasma samples using RT-qPCR. The discriminatory performance was assessed by calculating the Area Under the Curve (AUC). Reclassification metrics, including the Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) indexes, were utilized to evaluate enhancements in diagnostic accuracy. Among the 252 patients with suspected ACS, 50.8 % were diagnosed with ACS, and 13.9 % with NSTEMI. Initially, the association of lncRNA PDE4DIPP6 with ACS was investigated. Elevated levels of this lncRNA were observed in ACS patients compared to non-ACS subjects. No association was found between lncRNA PDE4DIPP6 levels and potential confounding factors, nor was a significant correlation with hs-cTnT levels (rho = 0.071). The inclusion of lncRNA PDE4DIPP6 on top of hs-cTnT significantly improved the discrimination and classification of ACS patients, as reflected by an enhanced AUC of 0.734, an IDI of 0.066 and NRI of 0.471. Subsequently, the lncRNA PDE4DIPP6 was evaluated as biomarker of NSTEMI. Elevated levels of the lncRNA were observed in NSTEMI patients compared to patients without NSTEMI. Consistent with previous findings, the addition of lncRNA PDE4DIPP6 to hs-cTnT improved the discrimination and classification of patients, increasing the AUC from 0.859 to 0.944, with an IDI of 0.237 and NRI of 0.658.
CONCLUSIONS: LncRNA PDE4DIPP6 offers additional diagnostic insights beyond hs-cTnT, suggesting its potential to improve the clinical management of patients with NSTEMI.
RESULTS: The study enrolled individuals presenting with suspected acute coronary syndrome (ACS). LncRNA quantification was performed in plasma samples using RT-qPCR. The discriminatory performance was assessed by calculating the Area Under the Curve (AUC). Reclassification metrics, including the Integrated Discrimination Improvement (IDI) and Net Reclassification Improvement (NRI) indexes, were utilized to evaluate enhancements in diagnostic accuracy. Among the 252 patients with suspected ACS, 50.8 % were diagnosed with ACS, and 13.9 % with NSTEMI. Initially, the association of lncRNA PDE4DIPP6 with ACS was investigated. Elevated levels of this lncRNA were observed in ACS patients compared to non-ACS subjects. No association was found between lncRNA PDE4DIPP6 levels and potential confounding factors, nor was a significant correlation with hs-cTnT levels (rho = 0.071). The inclusion of lncRNA PDE4DIPP6 on top of hs-cTnT significantly improved the discrimination and classification of ACS patients, as reflected by an enhanced AUC of 0.734, an IDI of 0.066 and NRI of 0.471. Subsequently, the lncRNA PDE4DIPP6 was evaluated as biomarker of NSTEMI. Elevated levels of the lncRNA were observed in NSTEMI patients compared to patients without NSTEMI. Consistent with previous findings, the addition of lncRNA PDE4DIPP6 to hs-cTnT improved the discrimination and classification of patients, increasing the AUC from 0.859 to 0.944, with an IDI of 0.237 and NRI of 0.658.
CONCLUSIONS: LncRNA PDE4DIPP6 offers additional diagnostic insights beyond hs-cTnT, suggesting its potential to improve the clinical management of patients with NSTEMI.
摘要：
背景：长非编码RNA（lncRNA）已成为有希望的诊断生物标志物。这里,我们研究了心脏表达和血浆可检测的lncRNAPDE4DIPP6作为非ST段抬高型心肌梗死（NSTEMI）的生物标志物，特别评估其增强高敏心肌肌钙蛋白（hs-cTnT）诊断效能的潜力。
结果：本研究纳入了疑似急性冠脉综合征（ACS）患者。使用RT-qPCR在血浆样品中进行LncRNA定量。通过计算曲线下面积(AUC)评估辨别性能。重新分类指标，包括综合歧视改进(IDI)和净重新分类改进(NRI)指数，用于评估诊断准确性的增强。在252例疑似ACS患者中，50.8%被诊断为ACS,和13.9%与NSTEMI。最初，研究了lncRNAPDE4DIPP6与ACS的相关性。与非ACS受试者相比,在ACS患者中观察到这种lncRNA水平升高。lncRNAPDE4DIPP6水平与潜在的混杂因素之间没有发现关联，与hs-cTnT水平也无显著相关性(rho=0.071)。在hs-cTnT之上包含lncRNAPDE4DIPP6显著改善了ACS患者的辨别和分类，增强的AUC为0.734，IDI为0.066，NRI为0.471。随后，lncRNAPDE4DIPP6被评估为NSTEMI的生物标志物。与没有NSTEMI的患者相比,在NSTEMI患者中观察到lncRNA水平升高。与以前的发现一致，将lncRNAPDE4DIPP6添加到hs-cTnT改善了患者的辨别和分类，AUC从0.859增加到0.944，IDI为0.237，NRI为0.658。
结论：LncRNAPDE4DIPP6提供了超越hs-cTnT的额外诊断见解，提示其改善NSTEMI患者临床管理的潜力。
结果：本研究纳入了疑似急性冠脉综合征（ACS）患者。使用RT-qPCR在血浆样品中进行LncRNA定量。通过计算曲线下面积(AUC)评估辨别性能。重新分类指标，包括综合歧视改进(IDI)和净重新分类改进(NRI)指数，用于评估诊断准确性的增强。在252例疑似ACS患者中，50.8%被诊断为ACS,和13.9%与NSTEMI。最初，研究了lncRNAPDE4DIPP6与ACS的相关性。与非ACS受试者相比,在ACS患者中观察到这种lncRNA水平升高。lncRNAPDE4DIPP6水平与潜在的混杂因素之间没有发现关联，与hs-cTnT水平也无显著相关性(rho=0.071)。在hs-cTnT之上包含lncRNAPDE4DIPP6显著改善了ACS患者的辨别和分类，增强的AUC为0.734，IDI为0.066，NRI为0.471。随后，lncRNAPDE4DIPP6被评估为NSTEMI的生物标志物。与没有NSTEMI的患者相比,在NSTEMI患者中观察到lncRNA水平升高。与以前的发现一致，将lncRNAPDE4DIPP6添加到hs-cTnT改善了患者的辨别和分类，AUC从0.859增加到0.944，IDI为0.237，NRI为0.658。
结论：LncRNAPDE4DIPP6提供了超越hs-cTnT的额外诊断见解，提示其改善NSTEMI患者临床管理的潜力。
