Key result
Higher atherogenic index of plasma linked to ~97% lower odds of technical success in CTO PCI.
Why the study?
Atherogenic index of plasma (AIP) is increasingly associated with coronary artery disease and adverse cardiovascular outcomes, but its role in predicting technical success in CTO PCI was unknown.
Does the atherogenic index of plasma predict technical success in patients undergoing PCI for chronic total occlusion?
Observational (n=197)
Does the atherogenic index of plasma predict technical success in patients undergoing PCI for chronic total occlusion?
Effect estimate: OR 0.03 (95% CI 0.01-0.12)
p-value: p=<0.001
The atherogenic index of plasma is an independent predictor of technical success in CTO PCI, providing incremental value over the J-CTO score for procedural planning.
Should not yet alter PCI strategy based on AIP; leaves open its predictive value pending prospective validation in larger cohorts.
OBJECTIVE: The atherogenic index of plasma (AIP) has been increasingly associated with coronary artery disease and adverse cardiovascular outcomes. This study aimed to evaluate the clinical relevance of AIP in predicting technical success in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). METHOD: This retrospective study included 197 patients who met the eligibility criteria. AIP was calculated as the base-10 logarithm of the triglyceride (TG)-to-high-density lipoprotein cholesterol (HDL-C) ratio (log10[TG/HDL-C]). Technical success was defined as successful recanalization of the CTO with residual stenosis < 30% and restoration of antegrade flow. RESULTS: Based on the receiver operating characteristic (ROC)-derived AIP cutoff value (0.802), patients were classified into low-AIP (n = 125, 64%) and high-AIP (n = 72, 36%) groups. Higher AIP levels were associated with lower technical success rates. To assess the incremental predictive value of AIP, two nested models (Model 1 and Model 2) were constructed. Model discrimination improved with the inclusion of AIP (area under the curve [AUC]: 0.73 vs. 0.83), and likelihood ratio testing confirmed a significant enhancement in model performance (P < 0.001). In both models, estimated glomerular filtration rate and the Japanese Chronic Total Occlusion (J-CTO) score remained independent predictors of CTO PCI technical success. In Model 2, AIP was also independently associated with technical success (odds ratio: 0.03, 95% confidence interval: 0.01-0.12, P < 0.001). Although AIP demonstrated a numerically higher AUC than the J-CTO score in ROC analysis for predicting CTO PCI success, the difference was not statistically significant (P = 0.097). CONCLUSION: AIP may serve as a useful predictor of technical success in chronic total occlusion percutaneous coronary intervention and may provide incremental value during procedural planning.
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Şengör et al. (2026) conducted an observational in Chronic total occlusion (CTO) (n=197). Atherogenic index of plasma (AIP) vs. Low AIP vs High AIP was evaluated on Technical success (successful recanalization of the CTO with residual stenosis < 30% and restoration of antegrade flow) (OR 0.03, 95% CI 0.01-0.12, p=<0.001). Higher atherogenic index of plasma was independently associated with lower technical success rates in chronic total occlusion PCI (OR 0.03; 95% CI 0.01-0.12; P<0.001).
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