Early identification of carotid vulnerable plaque in asymptomatic patients
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RESEARCH ARTICLE
Open Access
Early identification of carotid vulnerable plaque in asymptomatic patients Yungen Jiao1*† , Yahong Qin1,2†, Zhengang Zhang1, Hao Zhang1, Haiwei Liu1 and Chen Li1
Abstract Background: This study was to explore the influencing factors of atherosclerotic plaque formation and stability in patients with asymptomatic carotid atherosclerotic plaques, so as to identify the vulnerable plaques at early stage, and then find high-risk group of cardio-cerebrovascular events for early clinical intervention to reduce related mortality and disability. Methods: A total of 302 enrolled patients with asymptomatic carotid atherosclerotic plaques were divided into 3 groups based on the results of carotid artery color Doppler ultrasound: atherosclerotic unstable plaque (UP) group, atherosclerotic stable plaque (SP) group, and control group without plaques. Serum markers were measured by ELIS A. χ2 test, t test, Pearson correlation analysis, and Logistic multivariate regression analysis were used in the analysis, and P < 0.05 was considered statistically significant. Results: It revealed that high MMP-9, LOX-1and YKL-40 were independent risk factors for unstable plaque formation. The area under the curve (AUC) of serum markers combined with MMP-9, LOX-1 and YKL-40 was 0.850, with sensitivity 87.67%, specificity 81.13%, and diagnostic accuracy 84.92%, which was significantly better than the individual diagnostic efficacy of other three factors. The accuracy rate of Crouse Plaque Score (CPS) in the diagnosis of vulnerable plaques was 61.90%, the 10-year ICVD diagnosis accuracy rate was 56.75%, and the diagnostic accuracy of serum markers was significantly better than CPS and 10-year ICVD. Conclusion: Noninvasive cervical color Doppler ultrasound combined with serum markers MMP-9, LOX-1 and YKL40 have significant early recognition effect on asymptomatic carotid vulnerable plaque patients. Keywords: Carotid artery ultrasound, Atherosclerosis, Unstable plaque, Vulnerable plaque, Serum marker, Early recognition
Background Atherosclerosis (AS) is the root cause of cardiovascular and cerebrovascular diseases, including coronary artery disease and stroke. More than 4 million people die of cardiovascular and cerebrovascular disease every year in China, ranking the first in fatal diseases [1]. Atherosclerosis is an independent risk factor for cardiovascular and * Correspondence: [email protected] † Yungen Jiao and Yahong Qin contributed equally to this work. 1 Department of Cardiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, 45# Taizhou road, Yangzhou 225000, Jiangsu Province, China Full list of author information is available at the end of the article
cerebrovascular diseases. Plaque rupture and subsequent thrombosis are the main causes of myocardial infarction and stroke. With the continuous improvement of people’s living standards, the occurrence of cardiovascular and cerebrovascular events is showing a younger trend, and some senile diseases such as hypertension, cerebral infarctio
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