Thus, these findings underscore the critical role of Apo B in the manifestation of MI and IHD, as elevated levels of Apo B-containing lipoproteins primarily drive atherosclerosis.38 Moreover, reduced Apo A1 levels in these ASCVD subclasses (MI and IHD) suggest impaired reverse cholesterol transport, which may contribute to the lipid build-up and instability of plaques.13 Plaque rupture is a common cause of MI,41 making Apo A1 a crucial factor in these patients. This evidence concerns the gene APOB and myocardial ischemia.