ABSTRACT
Background: The risk factors for coronary and carotid plaque development are consistent. Coronary plaque rupture is a major cause of adverse cardiovascular events. Ultrasound can evaluate vulnerable carotid plaques and provide information for predicting vulnerable coronary plaques identified by optical coherence tomography (OCT). This study aimed to investigate the predictive role of non-invasive carotid ultrasound in OCT diagnosis of atherosclerotic vulnerable plaque. Methods: A total of 70 participants, including 35 patients with and 35 without vulnerable coronary plaque, were enrolled in this case-control study at Beijing Anzhen Hospital from 2016 to 2021. The data of 70 patients with suspected coronary heart disease who had undergone OCT examination during percutaneous coronary intervention (PCI) surgery and completed carotid ultrasound examination within 3 days before PCI were analyzed retrospectively. According to the OCT diagnostic criteria for vulnerable plaques, the patients were divided into the vulnerable-plaque group and the stable-plaque group. Univariate and binary logistic regression analyses assessed risk factors for vulnerable coronary plaque. Receiver operating characteristic (ROC) curve analysis was used to determine the predictive power of carotid plaque features. Results: The univariate analysis demonstrated that the differences in high-sensitivity C-reactive protein levels and carotid plaque characteristics (irregular fibrous cap, heterogeneous plaque, hypoechoic plaque, plaque calcification, and a plaque thickness of greater than 3 mm) between the two groups were statistically significant. The logistic multivariate regression analysis revealed that an irregular fibrous cap of a carotid plaque [odds ratio (OR) =4.819; 95% confidence interval (CI): 1.106-22.867; P=0.048] and a hypoechoic plaque (OR =9.632; 95% CI: 2.138-43.384; P<0.05) were independent risk factors for predicting vulnerable plaques of the coronary artery. Conclusions: Noninvasive carotid ultrasound is feasible and clinically valuable for predicting vulnerable and asymptomatic coronary plaques defined by OCT. With this method, adverse events can be diagnosed and treated in advance.
ABSTRACT
Objective: The goal of this study is to use superb microvascular imaging (SMI) to observe neovascularization in the carotid vessel wall to identify potential Takayasu's arteritis (TAK) inflammation markers. Methods: Bilateral carotid arteries from 96 patients with TAK were imaged by a Doppler ultrasound and SMI. The one-way analysis of variance (ANOVA) was used to document significant differences between the activity and inactivity stages of TAK and the factors closely related to its activity in the binary logistics regression equation. Clinical and laboratory data included age, gender, duration of disease, treatment history, NIH score, erythrocyte sedimentation rate (ESR), and high-sensitivity C-reactive protein. Imaging data included the arterial wall thickness, degree of lesion, SMI grade, and arterial aneurysm formation. Results: There were 45 patients in the active TAK stage and 51 in the inactive stage. The one-way ANOVA showed significant differences in SMI (p = 0.001) and ESR (p = 0.022) between the active and inactive groups. The binary logistics regression analysis showed that SMI was an independent risk factor for TAK activity (B = -1.505, S.E = 0.340, Wald = 19.528, OR = 0.222 95%, CI = 0.114-0.433, p < 0.01). Using SMI G1 or G2 as the cutoff values for the diagnosis of active TAK, the positive predictive value, sensitivity, and specificity were 60 and 86%, 84% and 56%, and 54% and 92%, respectively. Conclusion: The SMI grade is a potential marker of disease activity in patients with TAK.
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OBJECTIVE: This study was aimed to explore the impact of fish oil (Omega-3 fatty acids) on hostility and psychopathology among patients with acute violent schizophrenia. METHOD: Sixty seven acute hospitalized patients demonstrating violent behavior in the context of a schizophrenic illness, treated with antipsychotics, were randomly assigned to a supplement with either fish oil (N=32) or placebo (N=35) in a double-blind, placebo-controlled trial. Assessments were conducted at the baseline, week 4 and week 8. RESULTS: The symptoms and hostility decreased after treatment for 4 and 8 weeks in both groups, with no group differences. CONCLUSIONS: The current study did not find improvements in symptoms or hostility from the Omega-3 fatty acid supplementation in patients with schizophrenia. The implication is that Omega-3 fatty acids do not reduce psychopathology and hostility in acute patients with schizophrenia.
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OBJECTIVE: Human epididymis protein 4 (HE4), a precursor of human epididymis protein, has been recently identified as a new promising serum biomarker for ovarian carcinoma. We performed a systematic review of studies that investigated the use of HE4 in the diagnosis of ovarian cancer in patients with pelvic or gynecological masses. We also evaluated the diagnostic performance of HE4 for differentiating between patients with benign gynecological disease and those with ovarian cancer. METHODS: We searched PubMed database (1990-2011) to collect articles in English that evaluated the diagnostic value of HE4 in patients with gynecological or pelvic masses. Two reviewers independently assessed the methodological quality of each study using the quality assessment of diagnostic accuracy studies tool. The data were analyzed using Meta-Disc1.4 software. Meta-analysis of the reported sensitivity and specificity of each study and summary receiver operating characteristic (SROC) curve were performed. RESULTS: A total of 9 studies involving 1807 women were included. When the control group was composed of healthy women, the pooled sensitivity and specificity for HE4 in diagnosing ovarian cancer were 83% (95% confidence interval [CI], 77%-88%) and 90% (95% CI, 87%-92%), respectively. The area under the SROC curve was 0.9271. When the control group was composed of women with benign disease, the pooled sensitivity and specificity for HE4 were 74% (95% CI, 69%-78%) and 90% (95% CI, 87%-92%). The area under the SROC curve was 0.8853. CONCLUSION: The current analysis indicated that HE4 may be a valuable marker in the diagnosis of ovarian carcinoma. Serum HE4 detection is not only a useful preoperative test for predicting the benign or malignant nature of pelvic masses but has a potential to be used as an initial step in ovarian cancer screening strategy.
