Relationship between coronary CTA morphological parameters, serum ApoA1, ApoB/ApoA1, and prognosis of patients with coronary heart disease

To explore the relationship between coronary computed tomography angiography (CTA) morphological parameters, serum apolipoprotein A1 (ApoA1), the ratio of apolipoprotein B (ApoB) to ApoA1 (ApoB/ApoA1), and prognosis of patients with coronary heart disease (CHD). A total of 212 patients with CHD who were confirmed and underwent coronary CTA in the hospital were retrospectively enrolled between January 2020 and December 2022. The baseline clinical data of all patients were collected. The levels of serum ApoA1 and ApoB were detected, and the ApoB/ApoA1 ratio was calculated. The morphological parameters of coronary CTA [coronary artery stenosis degree (CASD), total plaque volume (TPV), coronary lumen volume (CLV), total plaque burden (TPB)] were obtained. According to the presence or absence of major adverse cardiovascular events (MACE) after 2 years of follow-up, patients were divided into event group (n = 64) and non-event group (n = 148). The influencing factors of prognosis were analyzed by multivariate Logistic regression analysis, and their predictive efficiency for prognosis was evaluated by receiver operating characteristic (ROC) curves. The proportions of patients with BMI ≥ 24 kg/m 2 and diabetes mellitus history in the event group were higher than those in the non-event group, while the proportion of statins use history was lower than that in the non-event group ( P < 0.05). CASD, TPV, TPB, ApoB/ApoA1, and APOB in the event group were higher than those in the non-event group, while levels of serum APOA1 were lower than those the in non-event group (P < 0.05). The results of multivariate analysis showed that a high TPB and a ApoB/ApoA1 were independent risk factors for MACE ( P < 0.05). ROC curves analysis showed that AUC values of CASD, TPV, TPB, ApoA1, ApoB, ApoB/ApoA1 and combined detection for predicting MACE were 0.735 (95 % CI: 0.670～0.793), 0.657 (95 % CI: 0.589～0.720), 0.858 (95 % CI: 0.803～0.902), 0.753 (95 % CI: 0.689～0.809), 0.618 (95 % CI: 0.549～0.684), 0.887 (95 % CI: 0.836～0.926) and 0.965 (95 % CI: 0.931～0.985), AUC of combined detection was greater than that of single index ( P < 0.05). The morphological parameters of coronary CTA combined with serum ApoA1 and ApoB/ApoA1 can be applied as effective evaluation indices for the prognosis of patients with CHD, and the predictive efficiency of combined detection is better.