Influence of Plasma Atherogenic Index on Coronary Artery Disease Severity: Insights From a Large-Scale Cohort Study in China

Background: The atherogenic index of plasma (AIP), calculated from triglyceride and high-density lipoprotein cholesterol levels, is associated with atherosclerosis and coronary artery disease (CAD). However, evidence concerning the impact of the AIP on CAD severity remains limited. This study aims to assess the correlation between AIP and the severity of CAD. Methods: This study included 19,929 hospitalized participants diagnosed with CAD. After excluding participants with missing data, aged >75 years, or diagnosed with chronic kidney disease or cancer, a total of 2561 individuals were included. The 2561 participants were divided into three AIP tertile groups: AIP1 (AIP <0.016, n = 854), AIP2 (0.016 ≤ AIP < 0.216, n = 853), and AIP3 (AIP ≥0.216, n = 854). In this study, CAD severity was determined by the count of coronary arteries exhibiting stenosis of 50% or greater. Multivessel CAD was defined as ≥50% stenosis in two or more major coronary arteries. The relationship between AIP and CAD severity was assessed using logistic regression models. Results: Results indicate that the AIP independently predicts CAD severity, with an odds ratio of 1.700 (95% confidence interval (CI): 1.160–2.491; p = 0.007). The AIP3 group demonstrated a significantly higher risk of multivessel CAD compared to the AIP1 group (odds ratio (OR), 1.441; 95% CI: 1.124–1.848; p = 0.004), particularly in patients without diabetes mellitus (OR, 1.421; 95% CI: 1.030–1.962; p = 0.033). Conclusions: The AIP was significantly associated with CAD severity, suggesting that it could be a convenient and valuable marker for severity stratification in patients with CAD in clinical practice.