The Diagnostic Value of Optical Coherence Tomography and CRP for Plaques in Patients with Coronary Heart Disease

QIAO Huibin; LIU Guangjun; LENG Wenjun

doi:10.12102/j.issn.1672-1349.2025.13.013

Abstract：Objective: To explore the diagnostic value of optical coherence tomography (OCT) and C-reactive protein (CRP) in coronary plaques of patients with coronary heart disease. Methods: A total of 50 patients with acute myocardial infarction who were admitted to our hospital's cardiology department from October 2020 to October 2022 and underwent coronary angiography were selected as the acute myocardial infarction group; another 50 patients with unstable angina pectoris were selected as the unstable angina pectoris group; and 30 suspected coronary heart disease patients were selected as the control group. Optical coherence tomography (OCT) was used to detect fibrous cap thickness, lipid core degree, lipid pool length, plaque area, etc., and serum brain natriuretic peptide (BNP), CRP, and troponin I (cTnI) levels were measured. Results: Compared with the control group, the unstable angina pectoris group showed lower fibrous cap thickness, higher lipid core degree, lipid pool length, plaque area, and elevated serum CRP, cTnI, interleukin (IL-17), and BNP (P < 0.05). Compared with the unstable angina pectoris group, the acute myocardial infarction group had lower fibrous cap thickness, higher lipid core degree, lipid pool length, plaque area, thin-cap fibroatheroma (TCFA), plaque rupture, and intraplaque calcification, along with higher serum CRP, cTnI, IL-17, and BNP (P < 0.05). CRP showed a negative correlation with fibrous cap thickness (r = -0.365, P < 0.001), and positive correlations with plaque area, lipid core degree, and lipid pool length (r values were 0.386, 0.379, 0.392, respectively, P < 0.001). The area under the curve (AUC) for OCT detection was 0.840, with a sensitivity of 80.23% and specificity of 76.08%, and a Yuden index of 0.510; for CRP detection, the AUC was 0.835, with a sensitivity of 70.79% and specificity of 68.32%, and a Yuden index of 0.58; when OCT was combined with CRP, the AUC reached 0.956, with a sensitivity of 95.36% and specificity of 82.28%, and a Yuden index of 0.87. Conclusion: OCT has good efficacy in the early detection of plaque formation in patients with coronary heart disease, and its diagnostic performance is high when combined with CRP.