A high atherogenic index of plasma (≥0.318) significantly increased the risk of major cardiovascular and cerebrovascular adverse events (HR 1.614) compared to a low index in type 2 diabetes patients after percutaneous coronary intervention.
Cohort (n=2,356)
No
Does a high atherogenic index of plasma (AIP) predict an increased risk of MACCEs in patients with type 2 diabetes mellitus undergoing PCI?
Effect estimate: HR 1.614 (95% CI 1.303-2.001)
Absolute Event Rate: 26.1% vs 17.7%
p-value: p=< 0.001
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.
Qin et al. (2020) conducted a cohort in Type 2 diabetes mellitus undergoing percutaneous coronary intervention (n=2,356). High atherogenic index of plasma (AIP ≥ 0.318) vs. Low atherogenic index of plasma (AIP < 0.318) was evaluated on Major cardiovascular and cerebrovascular adverse events (MACCEs) (HR 1.614, 95% CI 1.303-2.001, p=< 0.001). A high atherogenic index of plasma (≥0.318) significantly increased the risk of major cardiovascular and cerebrovascular adverse events (HR 1.614) compared to a low index in type 2 diabetes patients after percutaneous coronary intervention.