Expression Significance of Serum Circular RNA CDYL and Circular RNA ROBO2 in Patients with Acute Myocardial Infarction and the Value of Their Combined Prediction for Major Adverse Cardiovascular Events

Fang Wang, Rui Liu, Cuirong Zhang, Shenglin Liu Department of Cardiology, Shanghai East Hospital, School of Medicine, Tongji University, Shanghai, 200120, People’s Republic of ChinaCorrespondence: Shenglin Liu, Email [email protected]: To investigate the expression changes of circular RNAs CDYL and ROBO2 in the serum of patients with acute myocardial infarction (AMI), explore their potential association with the occurrence of major adverse cardiovascular events (MACE), and evaluate the clinical value of their combined detection in predicting MACE after percutaneous coronary intervention (PCI).Methods: A retrospective cohort study was conducted on 119 AMI patients who underwent PCI (observation group) between February 2023 and February 2024. Based on post-PCI MACE occurrence, patients were categorized into Group A (with MACE, n=47) and Group B (without MACE, n=72). Additionally, 100 healthy volunteers were enrolled as controls. Serum levels of circRNA CDYL and circRNA ROBO2 were measured by quantitative real-time polymerase chain reaction (qRT-PCR). Pearson correlation analysis assessed their relationship. Multivariate logistic regression identified factors independently associated with MACE. Receiver operating characteristic (ROC) curves evaluated the predictive performance of each circRNA and their combination for MACE.Results: Serum circRNA CDYL was significantly downregulated in AMI patients, while circRNA ROBO2 was upregulated, showing a strong negative correlation (r = − 0.659, P< 0.001). The MACE group exhibited lower circRNA CDYL and higher circRNA ROBO2 levels than the non-MACE group (P< 0.05). Multivariate analysis identified high circRNA ROBO2 as an independent risk factor for MACE, while high circRNA CDYL was a protective factor. The combined detection of both circRNAs predicted MACE with an area under the curve (AUC) of 0.901, significantly outperforming either marker alone (sensitivity=89.74%, specificity=80.51%).Conclusion: Serum circRNA CDYL and ROBO2 are significantly associated with MACE risk in AMI patients after PCI. Their combined detection shows promising predictive value. However, these findings from a retrospective study are preliminary and require validation in prospective cohorts and further mechanistic investigation.Keywords: acute myocardial infarction, circRNA CDYL, circRNA ROBO2, combined prediction, MACE