Plasma ApoB/AI: An effective indicator for intracranial vascular positive remodeling

Both vascular positive remodeling and apolipoprotein B/apolipoprotein AI (apoB/AI) are important risk factors for ischemic stroke. However, it is unclear whether apoB/AI level plays a role in vascular positive remodeling. This study aimed to investigate the association between apoB/AI and intracranial vascular positive remodeling. Symptomatic patients with intracranial artery 30–99% stenosis were recruited and underwent high-resolution magnetic resonance (MR) imaging. The levels of apolipoprotein B (apoB), apolipoprotein AI (apoAI) and apoB/AI were tested. Intracranial vascular remodeling index (RI) defined as the wall area ratio between maximal luminal narrowing and reference site was evaluated on MR images. Positive remodeling was defined as RI ≥1.05. The association between apoB/AI level and positive remodeling was respectively determined in anterior and posterior circulation. Of 65 recruited patients (mean age: 58.5 ± 10.6 years; 36 males), 25 (38.5%) had positive remodeling, of which 24 (36.9%) were in the posterior circulation group. Patients with positive remodeling had significantly higher apoB (1.0 ± 0.3 g/L vs. 0.8 ± 0.3 g/L, P = 0.003) and apoB/AI (1.0 ± 0.3 vs. 0.8 ± 0.2, P = 0.008) than those without. Univariate logistic regression showed that apoB/AI (OR: 2.302, 95%CI: 1.229–4.321, P = 0.009) was significantly associated with positive remodeling. After adjusted for confounders, the association of apoB/AI (OR: 2.935, 95%CI: 1.061–8.123, P = 0.038) with positive remodeling remained significant. ApoB/AI (OR: 76.110, 95%CI: 1.169–4953.287, P = 0.042) was significantly associated with positive remodeling in posterior circulation but not in anterior circulation. ApoB/AI is a potential indicator for intracranial vulnerable atherosclerosis characterized by positive remodeling, especially in posterior circulation. •ApoB/AI is significantly higher in patients with vascular positive remodeling.•ApoB/AI is a better predictor for vulnerable atherosclerosis than LDL.•ApoB/AI reflects the balance between atherogenic and antiatherogenic particles.•Positive remodeling is related to plaque instability and ischemic events.