Advanced Atherogenic Index for the Assessment of Consolidated Lipid Risk in Premature Coronary Artery Disease Patients in India

Abstract

Introduction:The high prevalence, severity, and prematurity of coronary artery disease (CAD) in the Indian population cannot be completely explained by the conventional lipid parameters and the existing lipid indices.Aims and Objectives:To calculate newly defined advanced atherogenic index (AAI) in premature CAD patients and compare it between cases and controls and Correlate its values with the existing indices.Material and Methods:One hundred and twenty premature CAD patients and an equal number of age and sex matched healthy individuals were included in this study. Lipid profile and nonconventional lipid parameters like oxidized Low density lipoprotein (OX LDL), small dense LDL (SD LDL), lipoprotein (a) apolipoprotein B (Apo B), and apolipoprotein A1 (Apo A1) were estimated and their values were used to define AAI and existing lipid indices like AI, lipid tetrad index (LTI) and lipid pentad index (LPI).Results:The mean age of cases and controls was 37.29 + 4.50 and 36.13 + 3.53 years, respectively. The value of AAI was highly significant in cases (3461.22 ± 45.20) as compared to controls (305.84 ± 21.80). AAI has shown better statistical significance and correlation (P < 0.0001, r = 0.737) as compared to the earlier indices such as AI (P < 0.01, r = 0.52), LTI (P < 0.001, r = 0.677) and LPI (P < 0.001, r = 0.622) in premature CAD. Kolmogorov D statistic and cumulative distribution function plot has shown that AAI can discriminate cases and controls more accurately as compared to the earlier indices.Conclusion:Statistically AAI appears to be a better marker of consolidated lipid risk in premature CAD patients as compared to the earlier indices.

Assessment of Hepatobiliary Status and Cardiometabolic Risk Markers among Type 2 Diabetes Mellitus Patients. A Cross-Sectional Study

“…In the comparison of the mean values of the parameters [LPI, CLTI, MLTI, TyG index, Lp(a)] between our study and the previous study comprising of a healthy group and a group of patients with diabetes and CVD, done in the Indian population, our results lie between the mean values of the above 2 groups [24,25]. Since in our study, we excluded patients having clinically established cardiac problems, these findings suggest that there is an increasing trend in these parameters from healthy controls to patients with diabetes and CVD.…”

Profile of coronary artery disease in indian rural youth (< 35 yrs)

“…3 In its severe form, it occurs below the age of 40 years. 4 Indians are prone to CAD at a much younger age. 5 Approximately 50% of first heart attacks occur before 55 years and 25% occur before 40 years of age.…”

Lipoprotein(a) is associated with premature coronary artery disease: a meta-analysis

“…The electronic database search identified 348 studies. After the screening, a total of 11 studies [6,[22][23][24][25][26][27][28][29][30][31] met the inclusion criteria. Individual study characteristics are presented in Table 1.…”

“…Study design and heterogeneous selection criteria may partly explain this discrepancy, for instance, Bansal et al . [23] have also excluded smokers from cases (of note smoking is one of the leading contributors in pCAD development [2]), Manocha et al . [26] excluded patients with a past history of CAD, and Haidari et al .…”

“…al. [23] have also excluded smokers from cases (of note smoking is one of the leading contributors in pCAD development [2]), Manocha et al [26] excluded patients with a past history of CAD, and Haidari et al [31] included patients with apparently symptomatic valvular heart disease undergoing preoperative screening.…”