Do elevated Atherogenic Index of Plasma (AIP) and Neutrophil-to-HDL Ratio (NHR) improve the identification of obstructive coronary heart disease in symptomatic adults with suspected premature CHD and a CAC score of zero?
In symptomatic younger adults with a CAC score of zero, elevated AIP and NHR biomarkers can help identify a higher-risk subgroup for non-calcified obstructive coronary heart disease.
A coronary artery calcium (CAC) score of zero is generally considered a strong negative predictor for coronary heart disease (CHD). However, it does not exclude obstructive disease in symptomatic adults, particularly younger patients with non-calcified plaque. We evaluated whether Atherogenic Index of Plasma (AIP) and Neutrophil-to-HDL Ratio (NHR) improve identification of obstructive CHD in this population. We analyzed 362 symptomatic adults with suspected premature CHD (men 0.13, NHR > 3.08), the dual-high phenotype was associated with higher odds of obstructive CHD (odds ratio OR 4.59, 95% confidence interval CI 1.90–11.07, P < 0.001) compared with the low AIP/low NHR group. In symptomatic adults with suspected premature CHD and CAC = 0, the dual-high phenotype (elevated AIP and NHR) identifies a higher-risk subgroup for non-calcified obstructive disease. These findings underscore the limitations of CAC scoring alone in this population.
Wang et al. (Sat,) studied this question.