Atherosclerotic
cardiovascular disease (ASCVD) continues to be a major health concern globally.
Apolipoprotein (
Apo) B/A1 ratio is a reliable predictor of ASCVD and an important factor in assessing the risk of
myocardial infarction. Tissue
prolapse (TP) is defined as the tissue extrusion into the lumen through the
stent struts after implantation, which is a significant factor for poor short-term outcomes such as acute and subacute
thrombosis, severe myocardial
necrosis, and vulnerable plaque. Therefore, the aim of this study was to investigate the relationship between
Apo B/A1, plaque vulnerability, and tissue
prolapse on optical coherence tomography (OCT). This study enrolled 199 patients with atherosclerotic
cardiovascular disease (ASCVD) who underwent
percutaneous coronary intervention (PCI). Both pre- and post-procedural optical coherence tomography (OCT) examinations were conducted to assess TP volume and plaque morphology. Logistic regression analyses were performed to identify potential risk factors for tissue
prolapse volume. Receiver operator characteristic (ROC) curve analysis was carried out to evaluate the value of the
Apo B/A1 ratio for tissue
prolapse volume. The high
Apo B/A1 ratio group showed a larger TP volume (P = 0.001) and a higher percentage of plaque
rupture and erosion in comparison to the low
Apo B/A1 ratio group (P = 0.022 and P = 0.008). The high
Apo B/A1 ratio group and the high TP volume group also had a higher proportion of thin-cap
fibroatheroma (TCFA) (P = 0.046, P = 0.021). Multivariate logistic regression analysis revealed that both
Apo B/A1 ratio (odds ratio [OR]: 1.041, 95% confidence interval [CI] 1.007-1.076; P = 0.019) and TCFA (OR: 3.199, 95%CI 1.133-9.031; 0.028) were significantly related to high TP volume. Furthermore, the area under the curve (AUC) for predictive value of TP volume was 0.635 for
Apo B/A1 (95% CI 0.554-0.717, P = 0.002) compared to 0.615 for
low density lipoprotein cholesterol (
LDL-C) (95% CI 0.533-0.697, P = 0.008). The
Apo B/A1 ratio is an independent predictor of TP volume on OCT and is related to plaque vulnerability.