A Novel Score for an Old Enemy: Atherogenic Plasma Index Predicts In-Stent Restenosis among Stable Angina Pectoris Patients

Plasma Index Predicts In-Stent Restenosis among Stable Angina Pectoris PatientsI n-stent restenosis (ISR) is defined as 50% or more nar- rowing of the stented segment of the coronary arteries.It commonly occurs within the first 12 months after stent implantation. [1]Despite advances in stent design, drug and polymer structure in modern DESs; the incidence of ISR varies between 5% and 10%, and therefore it remains an important clinical problem. [2,3]e predisposing factors and pathogenesis of DES-ISR remain unclear. [4]Predisposing factors are grouped under three main headings in relation to lesion, procedure and patient.Small vessel diameter, stent implantation in saphenous graft, osteal, long, and calcific lesions are the most common lesion-related factors.The most important patient-related risk factors are hypertension, diabetes and hyperlipidemia. [5,6]jectives: Although the association of Atherogenic index of plasma (AIP) with coronary artery disease (CAD) and atherosclerosis is known, the relationship between AIP and in-stent restenosis (ISR) remains unclear.We aimed to investigate the relationship between AIP and ISR in patients with stable angina pectoris (SAP) treated with drug-eluting stent (DES).Methods: Patients with a history of DES implantation following stable angina were evaluated between January 2015 and November 2019 in this observational and retrospective study.608 eligible patients were dichotomized into ISR+ (n=241) and ISR-(n=367).ISR was defined as the presence of 50% or greater stenosis.AIP was defined as log [TG/HDL-C].Results: AIP levels were significantly higher in patients who developed ISR compared with those who did not (0.33 [0.15-0.52]vs 0.06 [-0.08-0.21]respectively, p<0.001).The AUC value of AIP levels for predicting ISR was 0.746 (p<0.001).Multivariate logistic regression analysis revealed that AIP, diabetes mellitus, higher LDL-C levels and lower LVEF values were independently associated with ISR.Conclusion: Multivariate analysis revealed that AIP was strongly independently associated with ISR.Using this novel inexpensive and easily calculable index may provide early recognition of ISR in patients with SAP who were treated with DES.