The aforementioned treatment methods can accurately identify vulnerable plaques and analyze plaque characteristics, but they all belong to invasive examination. At present, in addition to traditional computed tomography (CT) and magnetic resonance imaging (MRI), intravascular ultrasound (IVUS), optical coherence tomography (OCT), and coronary arteriograpphy (CAG) have also developed and appeared. Therefore, early identification and prediction of vulnerable plaques are of great significance for the diagnosis and treatment of ACS. The high occult nature of ACS leads to high morbidity and mortality of patients. Occlusive plaques and nonobstructive plaques are formed in the later stage of the disease, and the nonobstructive plaques rupture and form occlusive thrombus. After being cleaned by macrophages, lesions occurred in the vascular wall. After the reaction, the two cells entered the vascular endothelial cells and moved to the intima. Some studies suggested that it may be due to the accumulation of blood-derived lipids in the lining of blood vessels and an immune reaction with white blood cells in the blood. Vulnerable plaques include all plaques with rupture tendency or surface erosion, and rupture plaques are the main ones with complex causes.
Therefore, the pathological basis of ACS includes vulnerable plaques, vulnerable myocardium, and vulnerable blood. Based on massive cell, animal experiments, and clinical studies, it was found that the main cause of ACS is the formation of vulnerable plaques in patients’ blood vessels and secondary acute vascular thromboembolism. More than half of the patients with ACS had no history and symptoms before onset. Acute coronary syndromes (ACS) include unstable angina pectoris and ST-segment and non-ST-segment elevation acute myocardial infarction. To date, many researchers focused on the mechanisms underlying the transition from chronic to acute coronary heart disease. Therefore, it is mainly affected by the combined effect of the wall shear stress (WSS) of blood on the vascular wall and the peripheral circumferential stress (CS) of the solid. Anatomically, the endothelial cells of the blood vessels in the intima are usually seen in direct contact with the blood. The media is located between the intima and the outer membrane, and its composition and thickness vary with different blood vessel types in the human body. The outer membrane is composed of loose connective tissue rich in elastic fibers and collagen fibers, which is responsible for supporting the vascular wall of the body. The intima, as the innermost layer of vascular wall, is the thinnest in structure and mainly composed of the endothelium and subendothelial layer. In terms of anatomical structure, arterial vessels are divided into the intima, media, and outer membrane from inside to outside. Coronary atherosclerotic heart disease, as a typical cardiovascular disease, is a chronic progressive inflammatory disease. Every year, many patients cause great pressure on medical institutions, which causes great burden to the country and the people. In China, cardiovascular diseases account for about half of the deaths caused by diseases and have become the number one cause of death in China. IntroductionĬardiovascular disease has become the leading cause of death worldwide.
The combination of multiple biochemical markers to predict vulnerable plaque was of high diagnostic value, and this method was convenient and noninvasive, which was worthy of clinical promotion. Area under curve (AUC) values corresponding to the five biochemical markers were 0.601, 0.523, 0.562, 0.519, 0.539, and the AUC value after the combination of the five indicators was 0.826. The patient’s age, history of hyperlipidemia, apolipoprotein B (apoB), adiponectin (ADP), and sE-Selection were risk factors for vulnerable plaque. CFD can accurately capture the hemodynamic characteristics around the plaque. Vulnerable plaques were predicted according to the distribution of biochemical markers in serum. Computational fluid dynamics (CFD) was used to simulate the hemodynamics around plaques, and the serum biochemical markers in 224 patients with low-risk acute coronary syndrome (ACS) were analyzed. Early prediction of vulnerable plaque is of great significance in the treatment of cardiovascular diseases. Vulnerable plaque is considered to be the cause of most clinical coronary arteries, and linear cytokines are an important factor causing plaque instability.
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