{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T14:24:35Z","timestamp":1777040675485,"version":"3.51.4"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T00:00:00Z","timestamp":1762905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82372581"],"award-info":[{"award-number":["82372581"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004735","name":"Hunan Provincial Natural Science Foundation of China","doi-asserted-by":"crossref","award":["2022JJ30082"],"award-info":[{"award-number":["2022JJ30082"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Health Research Project of Hunan Provincial Health Commission","award":["W20242007"],"award-info":[{"award-number":["W20242007"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Percutaneous coronary angiography remains the diagnostic gold standard for coronary artery disease. However, the complex and high-volume nature of the imaging data renders the clinical interpretation of coronary lesions a time-consuming, labor-intensive, and inherently subjective process. This retrospective study collected and preprocessed Coronary artery angiography (CAG) image data from 408 patients with acute myocardial infarction (AMI). An improved YOLOv4 algorithm was developed, validated on standard VOC datasets, and subsequently calibrated via transfer learning on the CAG training set for automated lesion detection and classification. The model-derived lesion characteristics were then statistically correlated with the occurrence of Major Adverse Cardiovascular Events (MACEs) during patient follow-up. The improved model achieved a post-modification mean Average Precision (mAP) of 84.72% (95% CI: 83.44\u201385.99%) on the VOC dataset. For coronary lesion detection, the model yielded an overall mean Average Precision (mAP) of 55.01%. Importantly, lesion characteristics automatically detected by the model\u2014specifically completely occluded lesions (Log-rank p = 0.003) and multibranching lesions (Log-rank p = 0.033)\u2014demonstrated a significant association with the cumulative incidence of MACEs. The innovative, improved YOLOv4 model exhibits robust performance in effectively and accurately detecting and classifying coronary lesions within AMI patient angiography imagery. This study provides a valuable AI-assisted diagnostic tool and offers preliminary insights for long-term prognostic assessment by seamlessly integrating deep learning-derived anatomical features with MACEs prediction.<\/jats:p>","DOI":"10.3390\/bioengineering12111241","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:56:47Z","timestamp":1762945007000},"page":"1241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["An Innovative Model for Diagnosing Lesions in Coronary Angiography Imagery Using an Improved YOLOv4 Model"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1246-3390","authenticated-orcid":false,"given":"Zhu","family":"Chen","sequence":"first","affiliation":[{"name":"Institute for Future Sciences & Hengyang Medical School, University of South China, Hengyang 421001, China"},{"name":"Department of Cardiovascular Medicine, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, China"},{"name":"Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yajie","family":"Chen","sequence":"additional","affiliation":[{"name":"Institute for Future Sciences & Hengyang Medical School, University of South China, Hengyang 421001, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiajia","family":"Si","sequence":"additional","affiliation":[{"name":"Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Changhu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Hunan Key Laboratory of Biomedical Nanomaterials and Devices, Hunan University of Technology, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaohan","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chengming","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fengling","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Institute for Future Sciences & Hengyang Medical School, University of South China, Hengyang 421001, China"},{"name":"Department of Cardiovascular Medicine, Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University, Zhuzhou 412007, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2149","DOI":"10.1016\/S0140-6736(21)02248-0","article-title":"Angiographic quantitative flow ratio-guided coronary intervention (FAVOR III China): A multicentre, randomised, sham-controlled trial","volume":"398","author":"Xu","year":"2021","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"734","DOI":"10.1136\/heartjnl-2020-318356","article-title":"Racial differences in management and outcomes of acute myocardial infarction during COVID-19 pandemic","volume":"107","author":"Rashid","year":"2021","journal-title":"Heart"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e815","DOI":"10.1161\/CIR.0000000000000959","article-title":"Invasive Management of Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Scientific Statement from the American Heart Association","volume":"143","author":"Henry","year":"2021","journal-title":"Circulation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"718","DOI":"10.1001\/jamacardio.2016.2049","article-title":"Updates on Acute Coronary Syndrome: A Review","volume":"1","author":"Eisen","year":"2016","journal-title":"JAMA Cardiol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1093\/eurheartj\/ehac594","article-title":"Inclisiran and cardiovascular events: A patient-level analysis of phase III trials","volume":"44","author":"Ray","year":"2023","journal-title":"Eur. 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