The Atherogenic Index of Plasma: A Powerful and Reliable Predictor for Coronary Artery Disease in Patients With Type 2 Diabetes

Abstract

We evaluated the predictive power of the atherogenic index of plasma (AIP) for coronary artery disease (CAD) in patients with type 2 diabetes mellitus (T2DM). A total of 3278 patients who underwent coronary angiography were consecutively enrolled, including 2052 patients with CAD and 1226 patients with T2DM but without CAD. Patients in the CAD group had higher levels of triglyceride (TG), total cholesterol, low-density lipoprotein cholesterol, AIP and a lower level of high-density lipoprotein cholesterol (HDL-C). In correlation analyses, AIP correlated positively with body mass index, log (homeostasis model assessment of insulin resistance), TG, remnant lipoprotein cholesterol, non–HDL-C, but negatively with age and HDL-C. Multivariate logistic regression analyses demonstrated that AIP was an independent risk factor for CAD in diabetic patients and was validated by multiple models. Furthermore, the ORs for CAD risk were raised with increasing AIP quartiles; ORs of AIP quartiles Q2–Q4 compared with Q1 were 1.56, 1.70, and 2.22, respectively ( Ps < .001), which suggested AIP was the lipid parameter that most strongly associated with incident CAD. In conclusion, AIP is a powerful and reliable biomarker for predicting CAD risk beyond individual lipid profiles in patients with T2DM.

Atherogenic Index of Plasma and the Risk of In-Stent Restenosis in Patients with Acute Coronary Syndrome beyond the Traditional Risk Factors

“…A higher AIP level was also associated with an increasingly atherogenic lipid phenotype and cholesterol esterification rete 8,9) . Moreover, our present study and prior studies suggested AIP was relevant to various cardiometabolic risk factors [10][11][12] .…”

“…Although the potential mechanisms underlying AIP and DES-ISR were unknown at present, several possible explanations were listed according to previous studies. First, this study and prior studies all suggested AIP correlates positively with various metabolic disorders such as insulin resistance, DM, hyperglycemia, and hyperuricemia 10,11) , all of which were well-established risk factors for ISR [29][30][31] . Second, remnant-lipoprotein cholesterol, as a risk factor for the occurrence and development of ISR 32,33) , is usually increased with increasing AIP levels 8,10) .…”

“…The ISR was defined as a lumen diameter stenosis ≥ 50% occurred at the segment inside the stent or involving its 5 mm-edges. The 2 independent intervention cardiologists were risk factors for ASCVD, such as insulin resistance, abdominal obesity, diabetes mellitus (DM), and metabolic syndrome [10][11][12][13] . Meanwhile, mounting evidence associated AIP with the prevalence and severity of coronary artery disease (CAD) 10,14) .…”

“…The 2 independent intervention cardiologists were risk factors for ASCVD, such as insulin resistance, abdominal obesity, diabetes mellitus (DM), and metabolic syndrome [10][11][12][13] . Meanwhile, mounting evidence associated AIP with the prevalence and severity of coronary artery disease (CAD) 10,14) . AIP was an independent risk factor for the rapid progress of coronary atherosclerosis 15,16) .…”

“…Currently, the link between AIP and ASCVD has been well established in previous epidemiological studies as well. Zhou et al Wang et al and Shanker et al reported AIP was an independent and powerful predictor for the presence of CAD, and adding it with family history to traditional risk factors models could improve predictive accuracy for CAD 10,14,24) . Meanwhile, recent evidence also confirmed that AIP To further confirm our findings, multicenter, randomized, and prospective studies were necessary.…”