Related Experiment Video
Updated: Jan 29, 2026
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease
Published on: August 9, 2024
Apolipoprotein B correlates with intra-plaque necrotic core volume in stable coronary artery disease
Takayuki Ohwada1, Takayuki Sakamoto1, Yuki Kanno2
1Fukushima Red Cross Hospital, Department of Cardiology, Fukushima City, Japan.
Insights
High apolipoprotein B (Apo-B) levels correlate with increased necrotic core (NC) in coronary artery lesions of stable coronary artery disease (SCD) patients. This suggests Apo-B may indicate unstable plaque in this population.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Medical Imaging
Background:
- Coronary artery disease (CAD) plaque composition is crucial for cardiovascular events.
- Lipid profiles, including low-density lipoprotein cholesterol (LDL-C) and apolipoprotein B (Apo-B), are key risk factors.
- Virtual histology intravascular ultrasound (VH-IVUS) allows detailed plaque characterization.
Purpose of the Study:
- To investigate the association between specific lipid markers and coronary plaque composition.
- To determine if Apo-B levels correlate with vulnerable plaque features, specifically necrotic core (NC) volume.
- To explore the utility of Apo-B as a biomarker for unstable plaque in stable coronary artery disease (SCD) patients.
Main Methods:
- VH-IVUS was used to quantify plaque components (fibrous, fibrofatty, necrotic core, dense calcium) in 115 SCD patients undergoing percutaneous coronary intervention (PCI).
- Plasma levels of LDL-C, high-density lipoprotein cholesterol (HDL-C), Apo-B, and Apo-A1 were measured prior to PCI.
- Patients were stratified into low Apo-B (LAB) and high Apo-B (HAB) groups based on the median Apo-B level.
Main Results:
- Patients in the HAB group exhibited significantly greater vessel, plaque, and %NC volumes compared to the LAB group.
- A significant positive correlation was found between %NC volume and both LDL-C and Apo-B levels across all patients.
- Multiple regression analysis identified male sex, Apo-A1, and Apo-B as significant predictors of %NC volume.
Conclusions:
- Elevated Apo-B levels are associated with a higher necrotic core component in coronary artery lesions of SCD patients.
- Apo-B may serve as a valuable biomarker for identifying unstable plaque characteristics in patients with stable coronary artery disease.
- These findings highlight the role of lipid metabolism in modulating plaque vulnerability.
Objective:
To determine the relationship between plaque composition and low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), apolipoprotein B (Apo-B), and Apo-A1 using virtual-histology intravascular ultrasound (VH-IVUS).
Methods:
We assessed plaque composition in patients with stable coronary artery disease (SCD) admitted to our hospital for percutaneous coronary intervention (PCI) between November 1, 2012, and March 10, 2015. Before PCI, fibrous (FI), fibrofatty (FF), necrotic core (NC), and dense calcium (DC) regions were evaluated using VH-IVUS, and the contributions of each to the culprit lesion volume were recorded. Plasma LDL-C, HDL-C, Apo-B, and Apo-A1 levels were assessed before PCI. The relationship between the regions on VH-IVUS and plasma lipid levels was assessed. Patients were categorized into low Apo-B (LAB) and high Apo-B (HAB) groups, based on the overall cohort median Apo-B level.
Results:
We enrolled 115 patients (median Apo-B, 91 mg/dL, male n = 88) with 57 and 58 patients in the LAB (Apo-B ≤ 90 mg/dL) and HAB (Apo-B ≥ 91 mg/dL) groups, respectively. Vessel, plaque, and %NC volumes were significantly greater in the HAB group than in the LAB group. The %FI, %FF, and %DC volumes were similar in both groups. In all 115 patients, the %NC volume correlated with LDL-C (r = 0.2353, P = 0.0114) and Apo-B (r = 0.2487, P = 0.0074) but not with HDL-C and Apo A-1. The high-sensitivity C-reactive protein level tended to be higher in the HAB group than in the LAB group. Multiple regression analysis showed that being male, Apo-A1, and Apo-B were significant predictors of %NC volume extent.
Conclusions:
Elevated Apo-B level was related to the %NC in target coronary artery lesions in SCD patients, suggesting a role of Apo-B as a biomarker of unstable plaque in this population.
More Related Videos
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
01:26Coronary Artery Disease II: Pathophysiology
01:27Coronary Artery Disease V: Interprofessional Care
01:30Coronary Artery Disease III: Clinical Manifestations
01:26Coronary Artery Disease IV: Preventive Measures
02:10The Nucleosome Core Particle
The paradox
Nucleosomes, paradoxically, perform two opposite functions simultaneously. On the one hand, their main responsibility is to protect the delicate DNA strands from physical damage and help achieve a higher compaction ratio. While on the other hand, they must allow polymerase enzymes to access DNA...