Incidence and expression of circulating cell free p53-related genes in acute myocardial infarction patients

Aim: the circulating rna levels are predictive markers in several diseases. we determined the levels of circulating p53-related genes in patients with acute st-segment elevation myocardial infarction (stemi),indicating major heart muscle damage. methods: plasma rna was extracted from the patients (n=45) upon their arrival to the hospital (stemi 0h) and at four hours post-catheterization (stemi 4h) as well as from controls (n= 34). results: of 18 circulating p53-related genes,nine genes were detectable. a significantly lower incidence of circulating p21 (p＜0.0001),notch1 (p=0.042) and btg2 (p＜0.0001) was observed in the stemi 0h samples in comparison to the stemi 4h and control samples. lower expression levels (2.1-fold) of circulating bnip3l (p=0.011),p21 (3.4-fold,p=0.005) and btg2 (6.3-fold,p=0.0001) were observed in the stemi 0h samples in comparison to the stemi 4h samples,with a 7.4-fold lower btg2 expression (p＜0.001) and 2.6-fold lower p21 expression (p=0.034) compared to the control samples. moreover,the bnip3l expression (borderline significance,p=0.0655) predicted the level of peak troponin,a marker of myocardial infarction. in addition,the bnip3l levels on admission (p= 0.0025),at post-catheterization (p=0.020) and the change between the groups (p=0.0079) were inversely associated with troponin. the bnip3l (p=0.0139) and p21 levels (p=0.0447) were also associated with a longer time to catheterization. conclusions: our results suggest that circulating downstream targets of p53 are inhibited during severe ami and subsequently re-expressed after catheterization,uncovering possible novel death-orsurvival decisions regarding the fate of p53 in the heart and the potential use of its target genes as prognostic biomarkers for oxygenation normalization. © 2015,japan atherosclerosis society. all rights reserved.