Deng F, Li D, Lei L, et al. - Plaque rupture, erosion, and thrombus in patients with atherosclerotic cardiovascular disease (ASCVD) were shown to be independently predicted by Apo(apolipoprotein) B/A1 ratio.

• This analysis comprised 320 ASCVD patients receiving percutaneous coronary intervention; assigned into acute coronary syndrome (ACS) or chronic coronary syndrome (CCS) group.

• Using intravascular optical coherence tomography, the morphology of culprit plaque was assessed.

• Higher Apo B/A1 ratio was seen in ACS vs CCS patients and it was also higher in patients with plaque rupture, erosion or thrombus vs those without culprit plaques.

• High percent of vulnerable plaques were noted in relation to the high Apo B/A1 ratio vs low ratio group.

• A negative association of Apo B/A1 ratio with fibrous cap thickness in lipid-rich plaque was evident.

• Apo B/A1 ratio yielded an area under the ROC curve 0.632, 0.624, and 0.670 for plaque rupture, erosion, and thrombus, respectively; higher values than that of low-density lipoprotein cholesterol.