[miR-376b-5p and immune-inflammatory indicators for predicting in-hospital mortality in acute myocardial infarction].

OBJECTIVE

To investigate the early predictive efficacy of serum microRNA-376b-5p (miR-376b-5p) combined with immuno-inflammatory markers for all-cause mortality during hospitalization in patients with acute myocardial infarction (AMI).

METHODS

A prospective observational study was conducted. A total of 316 patients with AMI admitted to the Department of Cardiovascular Medicine of Hengshui People's Hospital from June 2023 to June 2025 were enrolled. Peripheral venous blood was collected immediately before percutaneous coronary intervention (PCI, within 24 hours after admission) to detect serum miR-376b-5p, neutrophil/lymphocyte ratio (NLR), Systemic Immune Inflammation Index (SII), platelet/lymphocyte ratio (PLR) and high-sensitivity C-reactive protein (hs-CRP) levels. All patients underwent emergency or elective PCI. The outcome event was all-cause mortality during hospitalization, and patients were divided into a death group (52 cases) and a survival group (264 cases). The clinical data and the levels of the aforementioned indicators were compared between the two groups. Multivariate logistic regression analysis was used to identify the influencing factors of in-hospital mortality; receiver operator characteristic curves (ROC curves) were plotted to evaluate the predictive value of serum miR-376b-5p and immune inflammation indicators for in-hospital mortality risk in AMI patients, and the area under the curve (AUC) was calculated.

RESULTS

The proportion of patients with Killip class III in the death group and the levels of serum miR-376b-5p, NLR, SII, PLR, and hs-CRP were all higher than those in the survival group (all P<0.05). Multivariate logistic regression analysis showed that elevated levels of NLR [odds ratio (OR)=2.097, 95% confidence interval (95%CI) was 1.453-3.027], SII (OR=2.011, 95%CI was 1.286-3.144), PLR (OR=1.067, 95%CI was 1.034-1.101), and miR-376b-5p (OR=1.831, 95%CI was 1.282-2.616) were independent risk factors for in-hospital mortality in patients with AMI (all P<0.05). The ROC curve indicated that NLR, SII, and PLR all had predictive value for in-hospital mortality in patients with AMI, and the combined prediction of NLR+SII+PLR had a higher predictive value than each individual marker (AUC=0.859), with sensitivity and specificity of 82.69% and 76.89%, respectively. The AUC of serum miR-376b-5p for predicting in-hospital mortality in patients with AMI was 0.812, with sensitivity and specificity of 75.00% and 75.38%, respectively. The AUC of serum miR-376b-5p combined with NLR+SII+PLR increased to 0.903, which was higher than that of each individual marker (both P<0.05), with sensitivity and specificity of 88.46% and 82.58%, respectively.

CONCLUSIONS

Elevated serum miR-376b-5p, NLR, SII and PLR levels immediately before PCI are independent risk factors for in-hospital death in AMI patients. Serum miR-376b-5p combined with NLR+SII+PLR has a higher predictive value for in-hospital death in AMI patients.