Jingyuan Hou,1– 3 Ruiqiang Weng,2,4 Xiaodong Gu,2,4 Junli Zhao,3 Xia Li,3 Sudong Liu2– 4 

1Institute of Cardiovascular Diseases, Meizhou People’s Hospital, Meizhou, Guangdong, 514031, People’s Republic of China; 2Guangdong Provincial Engineering and Technological Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, Guangdong, 514031, People’s Republic of China; 3Meizhou Clinical College, Shantou University Medical College, Meizhou, Guangdong, 514031, People’s Republic of China; 4Institute of Basic Medical Sciences, Meizhou People’s Hospital, Meizhou, Guangdong, 514031, People’s Republic of China

Correspondence: Sudong Liu, Institute of Basic Medical Sciences, Meizhou People’s Hospital, No. 63 Xinfeng Road, Meijiang District, Meizhou, 514031, People’s Republic of China, Tel +86-753-2131-591, Email vanguard_1987@163.com

Objective: MascRNA is involved in regulating the immune inflammatory response, but its role in acute coronary syndrome (ACS) remains unclear. This study aims to investigate the diagnostic and prognostic value of plasma exosomal mascRNA for ACS.
Methods: A total of 140 ACS patients and 50 patient with non-ACS were enrolled. Exosomes were isolated from plasma utilizing ultracentrifugation, and mascRNA expression in exosomes was quantified by qRT-PCR. Major adverse cardiovascular events (MACEs) occurring during the 1-year follow-up after stent implantation were recorded. The diagnostic value of exosomal mascRNA for ACS was evaluated utilizing receiver operating characteristic (ROC) analysis. The association between exosomal mascRNA level and MACEs was assessed by Kaplan-Meier survival analysis and Cox proportional-hazards regression.
Results: Exosomal mascRNA expression was significantly elevated in ACS patients, and positively correlated with Gensini score, white blood cells and age. Exosomal mascRNA demonstrated a diagnostic value for ACS (AUC: 0.763, 95% CI: 0.702– 0.824). Combined detection of exosomal mascRNA with cTnI improved the diagnostic preformation for ACS (AUC: 0.866, 95% CI: 0.815– 0.916). Exosomal mascRNA expression was higher in patients with MACEs, and patients with high mascRNA exhibited low incidence of MACE-free survival. Cox regression analysis suggested that exosomal mascRNA was independently associated with the risk of MACEs (HR: 3.710, 95% CI: 2.158– 6.376, P < 0.001).
Conclusion: Plasma exosomal mascRNA has the potential to function as a diagnostic biomarker for ACS and as a predictor for the incidence of 1-year MACEs.

Keywords: mascRNA, exosome, acute coronary syndrome, ACS, biomarker