Objective To investigate the predictive value of miR-499 expression in peripheral blood of patients with acute myocardial infarction (AMI) in short-term prognosis.

Methods A total of 218 AMI patients were divided into good prognosis group (n=178) and poor prognosis group (n=40) according to the occurrence of major cardiovascular adverse events 90 days after admission. A total of 100 healthy volunteers who received physical examination during the same period were used as control group. The miR-499 expression level in peripheral blood between good and poor prognosis group was compared. ROC curve was used to analyze the predictive value of miR-499 expression in peripheral blood for poor short-term prognosis in patients with AMI. Logistic regression model was used to analyze the risk factors for poor short-term prognosis in AMI patients.

Results The miR-499 expression level in peripheral blood of AMI patients was higher than that of control group(P<0.01), and expression of patients with poor prognosis group was higher than that of patients with good prognosis group (P<0.01). The results of ROC curve showed that the optimal cut-off value of miR-499 expression level in peripheral blood for predicting poor short-term prognosis of AMI patients was 0.775, AUC was 0.823 (95%CI: 0.753-0.892), corresponding sensitivity and specificity were 71.11% and 70.00%, respectively. Logistic regression analysis found that preoperative Killip grade ≥Ⅱ, higher preoperative CK-MB peak, and the expression level of miR-499 in peripheral blood >0.775 were independent risk factors for poor short-term prognosis in AMI patients (P<0.05).

Conclusions High expression level of miR-499 in early peripheral blood of AMI patients after admission is an independent risk factor for poor prognosis, and has early predictive value for poor prognosis.