Jingshui Zhang,1,* Zufei Wu,1,2,* Niannian Liu,1 Li Liu,1 Qirui Xu,3 Xiaolin Ma,1 Zheng Huang,1 Zhen Li,1 Wenlong Ding,1 Shi Chen,2,4 CunMing Fang1 

1Department of Cardiology, Xuancheng People’s Hospital, Xuancheng, Anhui, People’s Republic of China; 2Department of Cardiology, the 904th Hospital of the PLA Joint Logistics Support Force, Wuxi, Jiangsu, People’s Republic of China; 3Department of Medicine, Auhui Health College, Chizhou, Anhui, People’s Republic of China; 4Department of Cardiology, Affiliated Wuxi Fifth Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Shi Chen, Email bwy0329@163.com CunMing Fang, Email 806030412@qq.com

Objective: To investigate the correlation between the serum homocysteine (HCY) to apolipoprotein A-1 (ApoA-1) ratio (HAR) and Coronary Artery Disease (CAD).
Methods: Patients who underwent coronary angiography due to chest pain at two medical centers were selected. Serum homocysteine (HCY), apolipoprotein A1 (ApoA-1), albumin, and other indicators were measured in each group, and the HAR was calculated for statistical analysis.
Results: (1) Restricted cubic spline analysis revealed a linear relationship between HAR and the incidence of CAD (P > 0.05). (2) The results of the multivariable logistic regression analysis suggested that HAR and other parameters were independent risk factors for CAD and severe CAD. The C-indexes of the column line chart model constructed based on the results of the multivariable logistic regression for CAD and severe coronary artery lesions were 0.719 and 0.837, respectively. (3) Correlation analysis revealed a significant positive correlation between HAR and the Gensini score. (4) The decision curve analysis results indicated that the predictive model and HAR have good predictive value for severe coronary artery lesions.
Conclusion: There is a discernible correlation between HAR and coronary artery disease (CAD), demonstrating predictive value for both CAD and severe CAD, thereby serving as a useful tool in the diagnosis and assessment of coronary heart disease.

Keywords: ratio of homocysteine to apolipoprotein A1, homocysteine, apolipoprotein A1, coronary artery disease