Early identification of carotid vulnerable plaque in asymptomatic patients

BMC Cardiovascular Disorders

Hao Zhang¹  Chen Li¹  Haiwei Liu¹  Zhengang Zhang¹  Yungen Jiao¹  Yahong Qin² 

[1] Department of Cardiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, 45# Taizhou road, 225000, Yangzhou, Jiangsu Province, China;Department of Cardiology, The Affiliated Hospital of Yangzhou University, Yangzhou University, 45# Taizhou road, 225000, Yangzhou, Jiangsu Province, China;521 Hospital of Norinco Group, 12# Zhangba East Road, 710065, Xi’an, Shaanxi Province, China;

关键词: Carotid artery ultrasound;    Atherosclerosis;    Unstable plaque;    Vulnerable plaque;    Serum marker;    Early recognition;   

DOI  :  10.1186/s12872-020-01709-5

来源: Springer

【 摘 要 】

BackgroundThis 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.MethodsA 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 ELISA. 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.ResultsIt 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.ConclusionNoninvasive cervical color Doppler ultrasound combined with serum markers MMP-9, LOX-1 and YKL-40 have significant early recognition effect on asymptomatic carotid vulnerable plaque patients.

【 授权许可】

CC BY