Department of Cardiology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xiwulu 157#, Xi'an, 710004, Shaanxi, China.
Cardiovasc Diabetol. 2021 Sep 15;20(1):188. doi: 10.1186/s12933-021-01381-9.
Apolipoprotein (Apo) A1 and Apo B are strongly associated with the risk of atherosclerotic cardiovascular disease (ASCVD). However, the relationship between the Apo B/A1 ratio and the morphology of coronary vulnerable plaques has not been fully elucidated in patients with ASCVD.
A total of 320 patients with ASCVD undergoing percutaneous coronary intervention were enrolled and assigned into acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) group. The morphology of culprit plaque was analyzed by intravascular optical coherence tomography. Association between the Apo B/A1 ratio and coronary vulnerable plaques were evaluated using logistic regression models and receiver operator characteristic (ROC) curve analyses.
The Apo B/A1 ratio was higher in ACS patients than CCS patients (0.77 ± 0.28 vs. 0.64 ± 0.22, P < 0.001) and it was also higher in patients with plaque rupture, erosion or thrombus than those without culprit plaques. The high Apo B/A1 ratio was associated with high percent of vulnerable plaques compared with low ratio group. The Apo B/A1 ratio was negatively related to fibrous cap thickness in lipid-rich plaque (r = - 0.228, P = 0.043). Univariate and multivariate logistic regression analyses revealed that the Apo B/A1 ratio was an independent factor of plaque rupture, erosion, and thrombus. The area under the ROC curve of the Apo B/A1 ratio for plaque rupture, erosion, and thrombus were 0.632, 0.624, and 0.670 respectively (P < 0.001 for all), which were higher than that of low-density lipoprotein cholesterol.
The Apo B/A1 ratio is an independent predictor for plaque rupture, erosion, and thrombus in patients with ASCVD.
载脂蛋白（Apo）A1 和 Apo B 与动脉粥样硬化性心血管疾病（ASCVD）的风险密切相关。然而，在 ASCVD 患者中，Apo B/A1 比值与冠状动脉易损斑块的形态之间的关系尚未完全阐明。
共纳入 320 例接受经皮冠状动脉介入治疗的 ASCVD 患者，并分为急性冠状动脉综合征（ACS）或慢性冠状动脉综合征（CCS）组。通过血管内光学相干断层扫描分析罪犯斑块的形态。使用逻辑回归模型和受试者工作特征（ROC）曲线分析评估 Apo B/A1 比值与冠状动脉易损斑块之间的关系。
ACS 患者的 Apo B/A1 比值高于 CCS 患者（0.77±0.28 比 0.64±0.22，P<0.001），斑块破裂、侵蚀或血栓形成患者的 Apo B/A1 比值也高于无罪犯斑块患者。高 Apo B/A1 比值与低比值组相比，易损斑块比例更高。Apo B/A1 比值与富含脂质斑块的纤维帽厚度呈负相关（r=-0.228，P=0.043）。单因素和多因素逻辑回归分析表明，Apo B/A1 比值是斑块破裂、侵蚀和血栓形成的独立因素。Apo B/A1 比值对斑块破裂、侵蚀和血栓形成的 ROC 曲线下面积分别为 0.632、0.624 和 0.670（均 P<0.001），高于低密度脂蛋白胆固醇。
Apo B/A1 比值是 ASCVD 患者斑块破裂、侵蚀和血栓形成的独立预测因子。
