| [objective]To explore the associations of serum biomarkers (ADP, sICAM-1, sVCAM-1, sE-Selectin, sP-Selectin, MPO, MCP-1) levels with the characteristics of plaques detected by coronary computed tomography angiography (CTA). To establish the hybrid forecasting models, and to evaluate the abilities of serum biomarkers to predict high-risk plaques detected by CTA in an asymptomatic, non-diabetic population at low/medium Framingham risk.[Method]The study population consisted of 400 asymptomatic individuals without proven diabetes. All cases underwent CTA examination, and blood samples were collected within 1 hour before the CT scans. We quantitatively and qualitatively assessed plaques. Serum biomarkers were examined by flow fluorescence immunmicrobead assay.400 valid cases were analyzed by SPSS 19.0 software.[Result]1. Objects of study:400 cases were collected. The mean age of the sample was 51.5±8 years (range:29 to 73 years); 75.5% of the participants were male.85 cases were at medium Framingham risk, and 315 cases were at low Framingham risk.2. Characteristics of plaques as assessed by coronary CT angiography:A total of 248 cases had atherosclerotic plaques in which 181 (45.25%) cases had high-risk plaques,108 (27%) cases had positive remodeling,101 (25.25%) cases had low density plaques,60 (15%) cases had spotty calcifications, and 6 (1.5%) cases had Napkin-ring sign, In addition,23 cases (5.75%) had plaques with LDP, PR and SC (LDP+PR+SC).3. Age (p=0.001), hyperlipidemia (p=0.015), apoB (p=0.011), ADP (p=0.015), sE-Selectin (p=0.019) were independent risk factors of high-risk plaques. AUC was 0.727, the sensitivity value was 81.6%, the specificity value was 56.3%, and the positive predictive value was 65.1%, the negative predictive value was75.4%.4. The effective functions of FRS and age, sex, hyperlipidemia, apoB, ADP, sE-Selectin for the prediction of high-risk plaques:AUC was 0.735, the sensitivity value was 75%, the specificity value was 64.5%, the positive predictive value was 67.9%, and the negative predictive value was 72.1%.5. There were no associations between serum biomarker (ADP. sICAM-1, sVCAM-1, sE-Selectin, sP-Selectin, MPO,MCP-1) levels and plaque burdens as assessed by coronary CTA.6. Establishments and validations of hybrid forecasting models:6.1 Discriminatory equations:The first classification function:Z,=-28.099+8.991x1+0.947x2+1.602x3+2.511x4+1.126x5+0.423x6The second classification function:Z2=-32.227+9.731 x1+1.008x2+2.339x3+3.360x4+0.189x5+1.075x6 (x1:sex, x2:age, x3. hyperlipidemia, x4:apoB, x5:ADP, x6:sE-Selectin)6.2 validations of hybrid forecasting models:The correct diagnosis rate was 69.8% by method of "Casewise results"; the correct diagnosis rate was 66.4% by method of "Cross Validation".[Conclusion]1. Decreased ADP and sE-Selectin levels are significantly associated with the presence of high-risk plaques-and particularly high-risk plaques with PR and LDP-in an asymptomatic, non-diabetic population at low/medium Framingham risk; sVCAM-1 is an independent risk factor of SC; sICAM-1 level increased in atherosclerotic individuals; sP-Selectin, MCP-1 and MPO have no associations with vulnerabilities of plaques as assessed by coronary CTA. The above 7 biomarkers have no associations with plaque burdens.2. The hybrid forecasting models of conventional CHD risk factors and some serum biomarkers have some values in predictions of high-risk plaques in an asymptomatic, non-diabetic population at low/medium Framingham risk. Coronary CTA may also be of more values for the risk stratifications of coronary CTA patients than conventional FRS. |
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