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Apolipoprotein B/A1 Ratio for Predicting Major Adverse Cardiovascular Events in Coronary Artery Disease: Development

Hongxu Zhu1, Qi Jin1

  • 1Department of Cardiology, Beijing Haidian Hospital, Beijing, 100080, People's Republic of China.

International Journal of General Medicine
|May 13, 2026
PubMed

Insights

The apolipoprotein B/A1 ratio effectively predicts major adverse cardiovascular events (MACE) in coronary artery disease (CAD) patients post-percutaneous coronary intervention (PCI). A developed nomogram aids in risk stratification for improved cardiovascular risk assessment.

Area of Science:

  • Cardiology
  • Biomarkers
  • Risk Prediction

Background:

  • The apolipoprotein B to apolipoprotein A1 (ApoB/A1) ratio is a key lipid marker for cardiovascular risk.
  • Patients with coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) require accurate risk assessment.

Purpose of the Study:

  • To develop and validate a nomogram for predicting major adverse cardiovascular events (MACE).
  • To incorporate the ApoB/A1 ratio into a predictive model for patients undergoing PCI.

Main Methods:

  • Retrospective cohort study of 2459 patients undergoing PCI, split into training and validation sets.
  • Utilized LASSO and multivariable Cox regression for variable selection and model building.
  • Assessed model performance using C-index, calibration curves, and decision curve analysis.

Main Results:

  • The ApoB/A1 ratio independently predicted MACE (HR 1.12; P<0.001).
  • The nomogram showed good discrimination (C-index 0.67-0.72) and calibration.
  • Risk stratification revealed significant differences in 5-year MACE-free survival rates (93.0% vs 89.9% vs 83.1%).

Conclusions:

  • The ApoB/A1 ratio is a significant predictor of MACE in CAD patients post-PCI.
  • The developed nomogram demonstrates potential for clinical risk prediction and stratification.
  • Further external validation in prospective studies is recommended before clinical application.
Abstract

Keywords:
apolipoprotein A-Iapolipoproteins Bcoronary artery diseasenomogramspercutaneous coronary interventionprognosis

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