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September 14, 2026Cardiology Research and PracticeOpen Access

Higher atherogenic index of plasma predicts ~218% greater slow/no-reflow risk after emergency PCI.

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Why the study?

Does the atherogenic index of plasma predict the occurrence of slow flow/no-reflow in patients with acute myocardial infarction undergoing emergency PCI?

Population

964 patients initially diagnosed with acute myocardial infarction who underwent emergency percutaneous…

Design

Cohort

Key result

The atherogenic index of plasma was identified as an independent risk factor for slow flow/no-reflow after emergency percutaneous coronary intervention in patients with acute myocardial infarction (OR 3.184).

Authors

QSQinyu SunYDYifan DengWZWeiyi Zhou

Discussion

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Overview

AIP may aid SF/NR risk stratification after emergency PCI in AMI; hypothesis-generating and should not yet change practice.

Key Points

  • To evaluate the association between the atherogenic index of plasma and the occurrence of slow flow or no-reflow in patients with acute myocardial infarction undergoing emergency percutaneous coronary intervention.
  • Retrospective analysis of 964 patients with acute myocardial infarction who underwent emergency percutaneous coronary intervention (registered as ChiCTR2500108501).
  • Patients were classified into a slow flow/no-reflow group (n = 251) or a normal flow group (n = 713) based on postoperative TIMI flow grade.
  • Predictive factors were assessed using LASSO regression, multivariable logistic regression, restricted cubic splines, ROC analysis, and nomogram modeling.
  • The atherogenic index of plasma was an independent predictor of postoperative slow flow/no-reflow (OR = 3.184, p < 0.05) with an AUC of 0.737.
  • Higher quartiles of the atherogenic index of plasma demonstrated a nonlinear elevation in slow flow/no-reflow risk.
  • A predictive nomogram combining the index with white blood cell count and triglycerides yielded an AUC of 0.745 with stable performance across subgroups.

Study Design

Type

Cohort (n=964)

Multicenter

No

Structured PICO

Does the atherogenic index of plasma predict the occurrence of slow flow/no-reflow in patients with acute myocardial infarction undergoing emergency PCI?

P
Population
964 patients aged 18 to 90 years with acute myocardial infarction undergoing emergency percutaneous coronary intervention, retrospectively analyzed to assess the predictive value of the atherogenic index of plasma for slow flow/no-reflow.
E
Exposure
Atherogenic index of plasma (AIP)
O
Outcome
Occurrence of slow flow/no-reflow (SF/NR) based on TIMI flow gradesurrogate

Main Result

Odds Ratio: 3.184 (95% CI 2.162–4.689)

p-value: p=<0.001

The atherogenic index of plasma is an independent predictor of slow flow/no-reflow following emergency PCI in patients with acute myocardial infarction.

Limitations

  • Mathematical redundancy between AIP and its component TGs in the same model
  • Exclusion of patients on preadmission statins or antiplatelet agents may have introduced selection bias
  • Key procedural variables such as ischemic time, thrombus burden, GPIIb/IIIa inhibitor use, and stent characteristics were not included
  • Subjective TIMI flow-based definition of SF/NR
  • Nomogram showed only modest improvement over AIP alone
  • Single-center, retrospective design without external validation

Cite This Study

Sun et al. (2026) conducted a cohort in Acute Myocardial Infarction (AMI) (n=964). Atherogenic Index of Plasma (AIP) vs. Lower AIP levels was evaluated on Occurrence of slow flow/no-reflow (SF/NR) after emergency PCI (OR 3.184, 95% CI 2.162-4.689, p=<0.001). The atherogenic index of plasma was identified as an independent risk factor for slow flow/no-reflow after emergency percutaneous coronary intervention in patients with acute myocardial infarction (OR 3.184).

synapsesocial.com/papers/6aa7afef79e9260bc85aacd9https://doi.org/10.1155/crp/4736031
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