What does this research mean for the field?

A high atherogenic index of plasma (≥0.34) is independently associated with an increased risk of major adverse cardiovascular events compared to a low index in patients with type 2 diabetes mellitus. Novelty: ClaimNovelty.CONFIRMATORY. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the prognostic value of the atherogenic index of plasma for predicting major adverse cardiovascular events and all-cause mortality in patients with type 2 diabetes mellitus.

August 23, 2021Open Access

Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Type 2 diabetes mellitus (n=10251). Intervention: High atherogenic index of plasma (AIP ≥ 0.34) vs. Low atherogenic index of plasma (AIP < 0.34). Primary outcome: Major adverse cardiovascular events (MACEs) (HR 1.194, 95% CI 1.049-1.360, p=0.007).

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Key result

A high atherogenic index of plasma (≥0.34) was independently associated with an increased risk of major adverse cardiovascular events (HR 1.194) compared to a low index in patients with type 2 diabetes mellitus.

Why the study?

The predictive utility of the atherogenic index of plasma was unknown among patients with type 2 diabetes mellitus.

Does a high atherogenic index of plasma (AIP) predict an increased risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus?

Key Points

To evaluate the prognostic value of the atherogenic index of plasma for predicting major adverse cardiovascular events and all-cause mortality in patients with type 2 diabetes mellitus.
Secondary analysis of the ACCORD trial evaluating N=10,251 randomized patients with long-lasting type 2 diabetes mellitus.
Receiver operating characteristic (ROC) curve analysis established an optimal atherogenic index of plasma (AIP) threshold of 0.34 to categorize patients into high and low risk groups.
Univariate and multivariable Cox proportional hazards regression models evaluated associations between AIP and primary (MACEs) and secondary (all-cause mortality) endpoints.
AIP served as an independent predictor for major adverse cardiovascular events across multivariable adjustments (Model 1: HR = 1.333, 95% CI: 1.205–1.474, P < 0.001; Model 2: HR = 1.171, 95% CI: 1.030–1.333, P = 0.016; Model 3: HR = 1.194, 95% CI: 1.049–1.360, P = 0.007).
Elevated AIP was significantly linked to all-cause mortality (Model 1: HR = 1.184, 95% CI: 1.077–1.303, P < 0.001), cardiovascular death (Model 3: HR = 1.264, 95% CI: 1.015–1.573, P = 0.036), and nonfatal myocardial infarction (Model 3: HR = 1.284, 95% CI: 1.071–1.539, P = 0.007).

Study Design

Type

Observational (n=10,251)

Multicenter

Yes

Structured PICO

Does a high atherogenic index of plasma (AIP) predict an increased risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus?

Population

10,251 patients with long-lasting type 2 diabetes mellitus (T2DM), aged 40-79 years, with HbA1c ≥7.5% and a history of CVD or at least two risk factors for cardiovascular diseases. Mean age 62.81 years, 61.45% male, recruited from 77 clinical sites across North America.

Intervention

High atherogenic index of plasma (AIP ≥ 0.34)

Comparator

Low atherogenic index of plasma (AIP < 0.34)

Outcome

Major adverse cardiovascular events (MACEs), including nonfatal myocardial infarction (MI), nonfatal stroke, and/or death from cardiovascular causescomposite

Main Result

Effect estimate: HR 1.194 (95% CI 1.049-1.360)

Absolute Event Rate: 19.85% vs 14.68%

p-value: p=0.007

The atherogenic index of plasma (AIP) is an independent prognostic biomarker that can predict the risk of major adverse cardiovascular events in patients with type 2 diabetes mellitus.

Discussion

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Implication

AIP may refine MACE risk stratification in T2DM; hypothesis-generating and requires prospective validation before clinical adoption.

Cite This Study

Fu et al. (2021) conducted an observational in Type 2 diabetes mellitus (n=10,251). High atherogenic index of plasma (AIP ≥ 0.34) vs. Low atherogenic index of plasma (AIP < 0.34) was evaluated on Major adverse cardiovascular events (MACEs) (HR 1.194, 95% CI 1.049-1.360, p=0.007). A high atherogenic index of plasma (≥0.34) was independently associated with an increased risk of major adverse cardiovascular events (HR 1.194) compared to a low index in patients with type 2 diabetes mellitus.

synapsesocial.com/papers/6a1c4ce4923c8e1e6e9cd719 https://doi.org/10.21203/rs.3.rs-829355/v1

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Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus

Key Points

Study Design

Structured PICO

Main Result

Discussion

Implication

Cite This Study

Also Consider

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