Traditional lipid parameters like low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC) are commonly used in evaluating cardiovascular risk. Recently, emerging biom Show more
Traditional lipid parameters like low-density lipoprotein (LDL), high-density lipoprotein (HDL), and total cholesterol (TC) are commonly used in evaluating cardiovascular risk. Recently, emerging biomarkers such as apolipoprotein B (ApoB) and apolipoprotein A1 (ApoA1) are proposed to provide improved accuracy in assessing atherosclerotic risk. This study examined the association between conventional and novel lipid parameters and plaque burden in statin-naïve acute coronary syndrome (ACS) patients. We enrolled 81 statin-naïve patients with ACS. Each underwent both standard and extended lipid profiling. Coronary angiograms were evaluated using the Gensini score to quantify plaque burden. All participants were followed for 28 days to monitor for major adverse cardiac events (MACE). The average age was 51 years, with males comprising 77%. The ST-segment elevation myocardial infarction (STEMI) was observed in 58% of cases, non-ST-segment elevation myocardial infarction (NSTEMI) in 31%, and unstable angina in 11%. There was a significant correlation between the Gensini score and TC/HDL ratio ( The ratios of TC/HDL, LDL/HDL, and ApoB levels were positively associated with coronary plaque burden. While conventional lipid parameters continue to serve well in cardiovascular risk assessment (CRA), ApoB presents a promising standalone marker for identifying atherogenic risk and may serve as a practical alternative in clinical practice. Show less