August 20, 2020Open Access
Atherogenic index of plasma and the risk of advanced subclinical coronary artery disease beyond traditional risk factors: An observational cohort study
Key Result
Higher atherogenic index of plasma (per 0.1 unit increase) was independently associated with an increased risk of obstructive coronary plaque (OR 1.079) beyond traditional risk factors.
Study Design
Type
Cohort (n=6,928)
Multicenter
No
Structured PICO
Does a higher atherogenic index of plasma predict advanced subclinical coronary artery disease in adults without overt renal dysfunction?
P
Population
6,928 adults (mean age 52.0, 57.4% male) evaluated by coronary computed tomography angiography (CCTA) for health check-up without overt renal dysfunction (eGFR >60 mL/min/1.73 m2) in South Korea.
I
Intervention
Higher Atherogenic Index of Plasma (AIP), calculated as the base 10 logarithm of the ratio of triglycerides to HDL-C concentrations (evaluated continuously per 0.1 unit increase and by quartiles).
C
Comparator
Lower Atherogenic Index of Plasma (AIP) levels (lowest quartile).
O
Outcome
Advanced subclinical coronary artery disease, defined as heavy coronary calcification (coronary artery calcium score [CACS] >100) or obstructive coronary plaque (OCP, defined as plaque with >50% stenosis) evaluated by CCTA.surrogate
The atherogenic index of plasma is independently associated with advanced subclinical coronary artery disease, suggesting its utility as a predictive marker for coronary atherosclerosis beyond traditional risk factors.
Main Result
Effect estimate: OR 1.079 (95% CI 1.033-1.127)
p-value: p=0.001
Limitations
- Retrospective, cross-sectional, and observational study design with potential selection bias
- Potential roles of other environmental risk factors, diet, or exercise were not evaluated
- Included only Korean adults, which may limit generalization to other populations
Abstract
BACKGROUND: Atherogenic lipoprotein profile of plasma is an important risk factor for atherosclerosis. The atherogenic index of plasma (AIP) has been suggested as a novel marker for atherosclerosis. HYPOTHESIS: AIP is a useful marker of advanced subclinical coronary artery disease (CAD) in subjects without overt renal dysfunction. METHODS: evaluated by coronary computed tomography angiography (CCTA) for health check-up were included. The relation of AIP to advanced CAD (heavy coronary calcification, defined as coronary artery calcium score CACS >100 or obstructive coronary plaque OCP, defined as plaque with >50% stenosis) was evaluated. RESULTS: All participants were stratified into four groups based on AIP quartiles. The prevalence of CACS >100 (group I lowest 4.7% vs group II 7.0% vs group III 8.8% vs group IV 10.0%) and OCP (group I 3.7% vs group II 6.4% vs group III 8.8% vs group IV 10.9%) (all P 100 (odds ratio OR 1.057, 95% confidence interval (CI) 1.010 to 1.106, P = .017; relative risk (RR) 1.048, 95% CI 1.009-1.089, and P = .015) and OCP (OR 1.079, 95% CI 1.033-1.127, P = .001; RR 1.069, 95% CI 1.031-1.108, P 60 years, male sex, hypertension, diabetes mellitus, dyslipidaemia, obesity, and proteinuria. CONCLUSION: AIP is independently associated with advanced subclinical CAD beyond traditional risk factors.