Background and Aims
Patients with plaque rupture (PR) present with different cardiovascular risks, clinical strategies, and outcomes from those with plaque erosion (PE). However, there are lack of noninvasive biomarkers to distinguish PE from PR.
Methods
A prospective analysis of 382 patients with ST-segment elevation myocardial infarction (STEMI) was conducted. Of these patients, 262 and 120 presented with PR and PE, respectively. An additional 83 patients diagnosed with stable angina pectoris were enrolled as control group. Peripheral blood monocytes were collected pre-percutaneous coronary intervention and used to evaluate the mRNA expression of
IL-4
,
IL-10
,
IL-1β
, and
TNF-α
in all patients.
Results
STEMI patients had higher
IL-4
,
IL-10
,
IL-1β
, and
TNF-α
expression than the control patients. The mRNA levels of
IL-4
,
IL-1β
, and
TNF-α
were significantly higher in PR patients than PE; however, no significant difference was observed in
IL-10
between PE and PR. The areas under the receiver-operating characteristic curves for
IL-4
,
IL-1β
, and
TNF-α
for PR versus PE were 0.685, 0.747, and 0.895, respectively. At the cut-off value of 2.52,
TNF-α
demonstrated a sensitivity of 70.61% and specificity of 93.33% for discriminating PR from PE patients. When added to the model of established clinical risk factors,
TNF-α
significantly improved the predictive accuracy of PR. Multivariable logistic regression analysis indicated that
TNF-α
mRNA level was independently associated with PR (odds ratio, 3.09; 95% confidence interval, 2.29–4.16; p < 0.001).
Conclusion
The inflammatory response of peripheral blood mononuclear cells in patients with PR was higher than that in patients with PE. TNF-α may be a potential biomarker for predicting PR that could facilitate risk stratification and management in STEMI patients.
Acute coronary syndrome is the leading cause of cardiac death and has a significant impact on patient prognosis. Early identification and proper management are key to ensuring better outcomes and have improved significantly with the development of various cardiovascular imaging modalities. Recently, the use of artificial intelligence as a method of enhancing the capability of cardiovascular imaging has grown. AI can inform the decision-making process, as it enables existing modalities to perform more efficiently and make more accurate diagnoses. This review demonstrates recent applications of AI in cardiovascular imaging to facilitate better patient care.
BACKGROUND: Coronary heart disease (CHD) significantly impacts human health. Traditional Chinese medicine (TCM) suggests a possible correlation between eye-image and CHD, but this relationship has not been fully explored in Western medicine. PURPOSE: We aim to investigate the potential causal relationship between eye-image features and CHD, as examined by coronary angiography (CAG). METHODS: The study selected patients hospitalized in the Department of Cardiology from November 15, 2021, to February 27, 2022. The selected patients were divided into two groups based on their CAG findings: the CHD group (at least one coronary lesion stenosis≥ 50%) and the control group (lesion stenosis<50%) RESURTS: The final analysis included 342 patients out of a total of 426 participants, of these, 165 patients (48.2%) were diagnosed with CHD. The study found that certain characteristics in the left region 5(L5) and right region ( R5) were associated with CHD, including L5 pink dark speckle (OR: 4.143, 95%CI: 1.135-15.124, P=0.031), L5 vascular tortuosity (OR: 0.234, 95%CI: 0.077- 0.71, P=0.010) R5 dark red blood vessels (known as Xue mai in TCM) (OR: 1.683, 95%CI: 1.035-2.738, P=0.036), and R5 yellowish mounds (OR: 2.083, 95%CI: 1.221-3.554, P= 0.007). Multivariate regression analyses showed that L5 vascular tortuosity had a negative correlation with CHD. CONCLUSION: Our study revealed that four types of eye-image features, namely pink dark speckle, vascular tortuosity, dark red blood vessels, and yellowish mounds are associated with CHD. Among these features, vascular tortuosity showed a negative correlation with CHD, which could potentially aid in the diagnosis of the disease. Key words: Eye-image; Coronary heart disease; Traditional Chinese medicine
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