The atherogenic index of plasma plays an important role in predicting the prognosis of type 2 diabetic subjects undergoing percutaneous coronary intervention: results from an observational cohort study in China

Abstract

Background Many studies have reported the predictive value of the atherogenic index of plasma (AIP) in the progression of atherosclerosis and the prognosis of percutaneous coronary intervention (PCI). However, the utility of the AIP for prediction is unknown after PCI among type 2 diabetes mellitus (T2DM). Methods 2356 patients with T2DM who underwent PCI were enrolled and followed up for 4 years. The primary outcome was major cardiovascular and cerebrovascular adverse events (MACCEs), considered to be a combination of cardiogenic death, myocardial infarction, repeated revascularization, and stroke. Secondary endpoints included all-cause mortality, target vessel revascularization (TVR), and non-target vessel revascularization (non-TVR). Multivariate Cox proportional hazards regression modelling found that the AIP was correlated with prognosis and verified by multiple models. According to the optimal cut-off point of the ROC curve, the population was divided into high/low-AIP groups. A total of 821 pairs were successfully matched using propensity score matching. Then, survival analysis was performed on both groups. Results The overall incidence of MACCEs was 20.50% during a median of 47.50 months of follow-up. The multivariate Cox proportional hazards regression analysis before matching suggested that the AIP was an independent risk factor for the prognosis of T2DM after PCI (hazard ratio [HR] 1.528, 95% CI 1.100–2.123, P = 0.011). According to the survival analysis of the matched population, the prognosis of the high AIP group was significantly worse than that of the low AIP group (HR (95% CI) 1.614 (1.303–2.001), P < 0.001), and the difference was mainly caused by repeat revascularization. The low-density lipoprotein-cholesterol (LDL-C) level did not affect the prognosis of patients with T2DM (P = 0.169), and the effect of the AIP on prognosis was also not affected by LDL-C level (P < 0.001). Conclusions The AIP, a comprehensive index of lipid management in patients with T2DM, affects prognosis after PCI. The prognosis of diabetic patients with high levels of the AIP included more MACCEs and was not affected by LDL-C levels. It is recommended to monitor the AIP for lipid management in diabetic patients after PCI and ensure that the AIP is not higher than 0.318. Trial registration This is an observational cohort study that does not involve interventions. So we didn’t register. We guarantee that the research is authentic and reliable, and hope that your journal can give us a chance.

Prognostic impact of atherogenic index of plasma (AIP) in type 2 diabetes mellitus patients with acute coronary syndrome undergoing percutaneous coronary intervention

“…Qin Z, et al retrospectively enrolled 2356 T2DM patients who underwent PCI and followed them for 4 years. They found that AIP was an independent predictor of major cardiovascular and cerebrovascular adverse events including cardiac death, MI, repeated revascularization, and stroke, regardless of clinical presentation [27].…”

“…As a consequence, we presume that AIP can better re ect the lipid characteristics of diabetic patients. Recently, AIP has been demonstrated to be associated with CV morbidity and mortality in general population and different patients groups [17][18][19][20][21][22][23][24][25][26][27][28]. However, the prognostic impact of AIP on admission among T2DM patients with ACS undergoing PCI has not been exclusively studied.…”

Atherogenic index of plasma predicts cerebrovascular accident occurrence in antineutrophil cytoplasmic antibody-associated vasculitis

“…Emerging evidences now clearly indicate that patients with CID are prone to cardiovascular diseases (CVD) such as cerebrovascular accident (CVA), coronary artery disease (CAD), and thromboembolic diseases [10][11][12]. Notably, atherogenic index of plasma (AIP), which is calculated based on serum TG and HDL-cholesterol, is one of the laboratory indices indicating atherogenic status, and this has been used to assess the extent of dyslipidemia and predict the potential of developing CVA and CAD in various medical conditions [13][14][15]. Given that patients with CID are more often affected by CVDs than in healthy subjects and that increase of TG and decrease of HDL-cholesterol is present in those with chronic in ammation, it is possible that AIP is elevated in AAV patients and is associated with CVA and CAD.…”

Prognostic value of atherogenic index of plasma in patients with type 2 diabetes and acute coronary syndrome

“…A recent study demonstrated that AIP was a useful marker for predicting adverse cardiovascular events in type 2 diabetic patients undergoing percutaneous coronary intervention (PCI) [6]. However, the association between AIP and survival among patients with type 2 diabetes and ACS remains undetermined.…”