THE VALUE OF EVALUATING THE EXTENT OF CORONARY ATHEROSCLEROSIS IN CORONARY HEART DISEASE BY APO B/APO A1 RATIO

Sha Sha*, hu Wei, Yi Na

The fourth hospital of Changsha, department of Internal Medicine-Cardiovascular NO.2, No. 70 Lu Shan Road, Changsha, Hunan

Objective: To investigate the value of evaluating the extent of coronary atherosclerosis in coronary heart disease (CHD) by apolipoprotein B / apolipoprotein A1 (ApoB / ApoA1) ratios. Methods: Participants were 227 patients who underwent coronary an- giography from January to December 2017. Participants were assigned to an acute coronary syndrome group (ACS group, n = 79) or stable angina group (SAP group, n = 95) based on the results of coronary angiography. The control group included 53 patients with normal angiographic examination. Participants were divided into either the high group (>55 points, n=80) or low group (0 to 55 points, n=147) based on their Gensini score. Blood lipid levels related to venous blood tests were collected from the study subjects, and the risk factors affecting coronary artery formation and the differences in blood lipid levels were compared. Logistic regression was used to analyze risk factors associated with high coronary artery Gensini score, and ROC curve analysis was used to diagnose the value of blood lipid index in coronary atherosclerosis.

Results: The male ratio, smoking rate, and UA level were statistically significantly higher in the ACS group than in the SAP and control groups (P<0.05). The smoking rate in the SAP group was significantly higher than that in the control group (P<0.05). The levels of HDL-C and apo A1 in ACS group and SAP group were lower than those in the control group. The ACS group was significantly lower than the SAP group (P<0.05). The ratios of TC/HDL-C and LDL-C/HDL-C were significantly higher in the ACS group than those in the SAP and control groups (P<0.05). The apo B/apo A1 ratio in the ACS group was significantly higher than that in the control group (P<0.05). The age, smoking rate, UA level, apo B/apo A1 ratio, TC/HDL-C ratio, and LDL-C/HDL-C ratio were greater in the high group than in the low group. On the other hand, HDL-C and apo A1 levels were lower in the high group (P<0.05). Logistic regres- sion analysis found that the age, sex, apo B/apo A1 ratio were risk factors for coronary artery high Gensini score, while apo A1 level was a protective factor. ROC curve analyses found that the apo B/apo A1 (AUC=0.627, 95% CI 0.554-0.700) and apo B (AUC=0.677, 95% CI 0.603-0.751) were the top two areas under the curve. The best diagnostic scores for coronary artery high Gensini score were 0.746 (specificity 71.25%, sensitivity 57.82%) and 1.006 g/L (specificity 62.50%, sensitivity 72.79%).

Conclusions: Apo B/apo A1 ratio was a risk factor for CHD. Apo B/apo A1 and apo B have high diagnostic value for CHD coronary atherosclerosis, and they are of great value for early prevention and intervention of CHD.