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Background@#and Purpose To evaluate whether the thrombus enhancement sign (TES) can be used to differentiate embolic large vessel occlusion (LVO) from in situ intracranial atherosclerotic stenosis (ICAS)-related LVO in the anterior circulation of patients with acute ischemic stroke (AIS). @*Methods@#Patients with LVO in the anterior circulation who underwent both non-contrast computed tomography (CT) and CT angiography and mechanical thrombectomy were retrospectively enrolled. Both embolic LVO (embo-LVO) and in situ ICAS-related LVO (ICAS-LVO) were confirmed by two neurointerventional radiologists after reviewing the medical and imaging data. TES was assessed to predict embo-LVO or ICAS-LVO. The associations between occlusion type and TES, along with clinical and interventional parameters, were investigated using logistic regression analysis and a receiver operating characteristic curve. @*Results@#A total of 288 patients with AIS were included and divided into an embo-LVO group (n=235) and an ICAS-LVO group (n=53). TES was identified in 205 (71.2%) patients and was more frequently observed in those with embo-LVO, with a sensitivity of 83.8%, specificity of 84.9%, and area under the curve (AUC) of 0.844. Multivariate analysis showed that TES (odds ratio [OR], 22.2; 95% confidence interval [CI], 9.4–53.8; P<0.001) and atrial fibrillation (OR, 6.6; 95% CI, 2.8–15.8; P<0.001) were independent predictors of embolic occlusion. A predictive model that included both TES and atrial fibrillation yielded a higher diagnostic ability for embo-LVO, with an AUC of 0.899. @*Conclusion@#TES is an imaging marker with high predictive value for identifying embo- and ICAS-LVO in AIS and provides guidance for endovascular reperfusion therapy.
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Objective To explore the association between plasma resistin levels and acute coronary syndrome. Methods Four hundred patients were divided into coronary heart disease (CHD) group（310）and control group（90）according to the coronary Angiography (CAG). And CHD group was divided into ACS subgroup（n＝217）and SAP subgroup（n＝93）according to the clinical information. 85 cases in CHD group were underwent 64-slice spiral computed tomography coronary artery imaging. The severity and extent of coronary lesions were analyzed by CAG and graded by means of Gensini coronary score system. Resistin level in plasma of all patients was determined by enzyme linked immunosorbent assay. Results Resistin levels in CHD group［(889.1±248.2)pg/ml］ were significant higher compared with the control group［(261.6±111.9)pg/ml］ (P＜0.05), and resistin levels in ACS subgroup［(1260.0±368.0)pg/ml］ were much higher than that in SAP subgroup［(518.3±128.4)pg/ml］ (P＜0.05). Conclusions The resistin levels of patients with acute coronary syndrome increased significantly and might be associated with the vulnerable plaque. Resistin levels and 64 slice spiral computed tomography coronary artery imaging can be used to detect the vulnerable plaque in CHD patients.
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Objective To investigate the relationship between the plasma adiponectin concentration and coronary arteriosclerosis change in patient with coronary heart disease(CHD).Method 142 patients were divided into CHD group and control group according to the Coronary Angiography(CAG).CHD group were further divided into stable angina pectoris(SAP)subgroup and acute coronary syndrome (ACS)subgroup according to the clinical property.According to the type of coronary change,CHD group wag divided into A type group, B type group and C type group,meanwhile according to the degree of coronary lesion,CHD group was divided into light stenosis group, moderate stenosis group and severe stenosis group.The plasma adiponectin concentration was measured by ELISA.Results The plasma adiponectin concentration in CHD group was significant lower than that in control group.The plasma adiponectin concentration in ACS subgroup was significant lower than that in SAP subgroup.The plasma adiponectin concentration decreased gradually from A type group to C type group and from light stenosis group to severe stenosis group(P＜0.001).Conclusions Adiponectin is a negative regulatory factor of coronary atherosclerosis,and Hypoadiponectin may be used to predict the change of coronary arteriosclerosis and the stability of plaque.
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Objective To investigate the relation between activator protein-1(AP-1)and coronary atheroselerotic changes and the potential role of AP-1 in the stabilization of atherosclerotic plaques in patients with coronary heart disease(CHD).Method 142 patients were included in this study and divided into CHD group(107)and control group(35)according to coronary angiography(CAG).The CHD group was further divided into a stable angina pectoris(SAP)group(32)and all acute coronary syndrome(ACS)group (75)according to the clinical manifestations.In addition,the CHD group was divided into A type group,B type group and C type group according to the standard of ACC/AHA coronary change in 1988.Meanwhile,the CHD group was further divided into light stenosis group,moderate stenosis group and severe stenosis group according to the degree of coronary lesion.The lysate of cells was obtained through lysis of the leucocyts from peripheral blood with cell lysis buffer.The amount of Phospho.c-Jun in lysate was measured with enzyme-linked immunosorbent assay(ELISA).The results were demonstrated with absorbance,which reflects the amount of AP-1.Results The main coronary changes in the SAP group were A type(68.7%)and the changes were mainly of light degree(53.1%);the main coronary changes in the ACS group were B type(52.0%)or C type(37.3%)and the changes were mainly of heavy degree(66.7%).The absorbance of Phospho-c-Jun in CHD group was significantly higher than that in the control subjects (1.43±0.33 vs 0.71±0.13,P＜0.001).The absorbance of Phospho-c-Jun in the ACS group was significantly higher than that in the SAP group(1.56±0.28 vs 1.14±0.25,P＜0.001).The absorbance of Phospho-c-Jun increased gradually from A type group to C type group(1.18±0.27 vs 1.42±0.26 vs 1.71±0.27,P＜0.001)and from light stenosis group to severe stenosis group(1.09±0.20 vs 1.37±0.26 ys 1.60±0.29,P＜0.001).Conclusion There is a significant relationship between AP-1 and coronary atherosclerotic changes.AP-1 may be a factor that can predict coronary arteriosclerotic progression and stability of the plaque.
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Objective To investigate the relation between plasma macrophage migration inhibitory factor(MIF) concentration and the activity of activator protein-1(AP-1) in peripheral blood and coronary heart disease(CHD),and their relation with coronary arteriosclerosis plaques in patients with CHD.Methods One hundred and forty two patients were divided into coronary heart disease(CHD) group(n=107) and control group(n=35) according to coronary angiographic(CAG) result.The CHD group was further divided into stable angina pectoris(SAP) group(n=33) and acute coronary syndrome(ACS) group(n=75) according to clinical manifestations.In addition,according to the type of coronary lesions,the CHD group was further divided into the type A lesion(n=30) group,type B group(n=48) and type C group(n=29).According to the degree of coronary stenosis,the CHD group was also divided into mild stenosis group(n=21),moderate stenosis group(n=31) and severe stenosis group(n=55).The amount of Phospho-c-Jun in lysate and plasma MIF concentration were measured by enzyme-linked immunosorbent assay(ELISA).The results of Phospho-c-Jun was demonstrated with absorbance.Which reflect the amount of AP-1.Results The absorbance of Phospho-c-Jun in the CHD group was higher than that in the control(1.43?0.33 vs 0.71?0.13,P