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      Aberrant expression of miR-483-5p in patients with asymptomatic carotid artery stenosis and its predictive value for cerebrovascular event occurrence

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          Abstract

          MicroRNAs (miRNAs/miRs) may be used as novel promising diagnostic and prognostic biomarkers for various diseases, including asymptomatic carotid artery stenosis (ACAS). The present study aimed to investigate the abnormal expression of microRNA-483-5p (miR-483-5p) in patients with ACAS and to evaluate its diagnostic value for ACAS screening and its predictive value for cerebrovascular events. A total of 128 patients with ACAS and 76 healthy controls were included in the present study. The expression of miR-483-5p in serum was measured by reverse transcription-quantitative PCR. Receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of miR-483-5p in patients with ACAS. Kaplan-Meier curves were drawn and Cox regression analysis was used to determine the predictive value of miR-483-5p for cerebrovascular events in patients with ACAS. Serum miR-483-5p levels were significantly increased in patients with ACAS as compared with those in healthy controls. The expression of miR-483-5p was significantly associated with diabetes (P=0.011), dyslipidemia (P=0.047) and the degree of carotid stenosis (P=0.006) in patients with ACAS. In addition, the area under the ROC curve was 0.910, with a sensitivity of 80.5% and a specificity of 89.5% at the cutoff value of 0.705, indicating that serum miR-483-5p expression has a certain diagnostic value in patients with ACAS. Furthermore, the patients with high miR-483-5p expression had a higher proportion of cerebrovascular events than patients with low miR-483-5p levels (log-rank P=0.011) and miR-483-5p was an independent prognostic marker for predicting the occurrence of cerebrovascular events in patients with ACAS. The results indicated that miR-483-5p expression is significantly increased in patients with ACAS and that abnormal miR-483-5p expression may be a candidate biomarker for ACAS diagnosis and the prediction of cerebrovascular event occurrence.

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          Most cited references39

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          Analyzing real-time PCR data by the comparative C(T) method.

          Two different methods of presenting quantitative gene expression exist: absolute and relative quantification. Absolute quantification calculates the copy number of the gene usually by relating the PCR signal to a standard curve. Relative gene expression presents the data of the gene of interest relative to some calibrator or internal control gene. A widely used method to present relative gene expression is the comparative C(T) method also referred to as the 2 (-DeltaDeltaC(T)) method. This protocol provides an overview of the comparative C(T) method for quantitative gene expression studies. Also presented here are various examples to present quantitative gene expression data using this method.
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            Prevention of disabling and fatal strokes by successful carotid endarterectomy in patients without recent neurological symptoms: randomised controlled trial.

            Among patients with substantial carotid artery narrowing but no recent neurological symptom (stroke or transient ischaemia), the balance of surgical risks and long-term benefits from carotid endarterectomy (CEA) was unclear. During 1993-2003, 3120 asymptomatic patients with substantial carotid narrowing were randomised equally between immediate CEA (half got CEA by 1 month, 88% by 1 year) and indefinite deferral of any CEA (only 4% per year got CEA) and were followed for up to 5 years (mean 3.4 years). Kaplan-Meier analyses of 5-year risks are by allocated treatment. The risk of stroke or death within 30 days of CEA was 3.1% (95% CI 2.3-4.1). Comparing all patients allocated immediate CEA versus all allocated deferral, but excluding such perioperative events, the 5-year stroke risks were 3.8% versus 11% (gain 7.2% [95% CI 5.0-9.4], p<0.0001). This gain chiefly involved carotid territory ischaemic strokes (2.7% vs 9.5%; gain 6.8% [4.8-8.8], p<0.0001), of which half were disabling or fatal (1.6% vs 5.3%; gain 3.7% [2.1-5.2], p<0.0001), as were half the perioperative strokes. Combining the perioperative events and the non-perioperative strokes, net 5-year risks were 6.4% versus 11.8% for all strokes (net gain 5.4% [3.0-7.8], p<0.0001), 3.5% versus 6.1% for fatal or disabling strokes (net gain 2.5% [0.8-4.3], p=0.004), and 2.1% versus 4.2% just for fatal strokes (net gain 2.1% [0.6-3.6], p=0.006). Subgroup-specific analyses found no significant heterogeneity in the perioperative hazards or (apart from the importance of cholesterol) in the long-term postoperative benefits. These benefits were separately significant for males and females; for those with about 70%, 80%, and 90% carotid artery narrowing on ultrasound; and for those younger than 65 and 65-74 years of age (though not for older patients, half of whom die within 5 years from unrelated causes). Full compliance with allocation to immediate CEA or deferral would, in expectation, have produced slightly bigger differences in the numbers operated on, and hence in the net 5-year benefits. The 10-year benefits are not yet known. In asymptomatic patients younger than 75 years of age with carotid diameter reduction about 70% or more on ultrasound (many of whom were on aspirin, antihypertensive, and, in recent years, statin therapy), immediate CEA halved the net 5-year stroke risk from about 12% to about 6% (including the 3% perioperative hazard). Half this 5-year benefit involved disabling or fatal strokes. But, outside trials, inappropriate selection of patients or poor surgery could obviate such benefits.
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              2015 American Heart Association/American Stroke Association Focused Update of the 2013 Guidelines for the Early Management of Patients With Acute Ischemic Stroke Regarding Endovascular Treatment: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

              The aim of this guideline is to provide a focused update of the current recommendations for the endovascular treatment of acute ischemic stroke. When there is overlap, the recommendations made here supersede those of previous guidelines.
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                Author and article information

                Journal
                Exp Ther Med
                Exp Ther Med
                ETM
                Experimental and Therapeutic Medicine
                D.A. Spandidos
                1792-0981
                1792-1015
                October 2021
                02 August 2021
                02 August 2021
                : 22
                : 4
                : 1101
                Affiliations
                [1 ]The Fourth Department of Encephalopathy, Weifang Hospital of Traditional Chinese Medicine, Weifang, Shandong 261041, P.R. China
                [2 ]Brain Center, Sunshine Union Hospital, Weifang, Shandong 261000, P.R. China
                [3 ]Department of Neurology, Liaocheng People's Hospital, Liaocheng, Shandong 252000, P.R. China
                Author notes
                Correspondence to: Dr Xiaoling Wang, Department of Neurology, Liaocheng People's Hospital, 45 Huashan Road, Liaocheng, Shandong 252000, P.R. China wangxl@ 123456lchospital.cn

                *Contributed equally

                Article
                ETM-0-0-10536
                10.3892/etm.2021.10536
                8383747
                34504555
                c987bf97-66be-4994-8934-6fb29eab8da5
                Copyright: © Li et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

                History
                : 06 January 2021
                : 18 June 2021
                Funding
                Funding: The present study was funded by a Project of Weifang Science and Technology Development (grant no. 2018YX054) and a Scientific Project of Weifang Health and Family Planning Commission (grant no. wfwsjs2018133).
                Categories
                Articles

                Medicine
                microrna-483-5p,asymptomatic carotid artery stenosis,diagnosis,prognosis,transient ischemic attacks

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