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.

中文翻译：

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动脉粥样硬化性心血管疾病患者载脂蛋白 B/A1 比值与冠状动脉斑块易损性的关系：血管内光学相干断层扫描研究

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形态之间的关系尚未完全阐明。共有320例ASCVD接受经皮冠状动脉介入治疗的患者被纳入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接受者操作特征 (ROC) 曲线分析评估 Apo B/A1 比率与冠状动脉易损斑块之间的关联。ACS 患者的 Apo B/A1 比值高于 CCS 患者（0.77 ± 0.28 vs. 0.64 ± 0.22，P < 0. 001），斑块破裂、糜烂或血栓的患者也高于没有罪魁祸首斑块的患者。与低比率组相比，高 Apo B/A1 比率与高百分比的易损斑块相关。Apo B/A1 比率与富含脂质的斑块中的纤维帽厚度呈负相关（r = - 0.228，P = 0.043）。单变量和多变量逻辑回归分析显示，Apo B/A1 比值是斑块破裂、侵蚀和血栓的独立因素。Apo B/A1 比值对斑块破裂、糜烂和血栓的 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、侵蚀和血栓的独立预测因子。