What is the clinical evidence from this study?

Study design: Case-Control. Population: Mitral Annular Calcification (n=741). Intervention: Atherogenic index of plasma vs. Lower atherogenic index of plasma. Primary outcome: Presence of mitral annular calcification (OR 2.460, 95% CI 1.984-3.049, p=<0.001).

July 6, 2022Open Access

Atherogenic Index of Plasma Is an Independent Predictor of Mitral Annular Calcification

Q: What are the key findings of this study?

Atherogenic index of plasma was independently associated with the presence of mitral annular calcification (OR 2.460).

SUsezen baglan uzungetSivas State Hospital KSKader Eliz SahinAdıyaman University

Key Result

Atherogenic index of plasma was independently associated with the presence of mitral annular calcification (OR 2.460).

Study Design

Type

Case-Control (n=741)

Multicenter

Structured PICO

Does a higher Atherogenic Index of Plasma predict the presence of mitral annular calcification in adult cardiology outpatients?

Population

741 adults (mean age 65.5 years, 59.6% female) free of coronary artery disease and lipid-lowering medications were retrospectively evaluated for mitral annular calcification.

Exposure

High Atherogenic Index of Plasma (AIP) and other atherogenic indices (AC, CRI-1, CRI-2)

Comparator

Low Atherogenic Index of Plasma (AIP) / Patients without MAC

Outcome

Presence of mitral annular calcification (MAC) diagnosed by transthoracic 2-dimensional echocardiographysurrogate

The Atherogenic Index of Plasma is an independent predictor of mitral annular calcification, suggesting a shared lipid-driven pathophysiological mechanism with atherosclerosis.

Main Result

Odds Ratio: 2.46 (95% CI 1.984–3.049)

p-value: p=<0.001

Limitations

Retrospective study design
Did not evaluate the severity of MAC by echocardiography or other imaging modalities
Echocardiography evaluation may have limitations due to imaging quality
Analysis based on a spot blood measurement, lacking prognostic role over long periods

Abstract

Abstract Background: In the latest reports, atherogenic indices have been related to acute coronary syndromes, stable coronary artery disease, heart failure and future cardiac events. Conventional atherosclerosis risk factors have been associated with mitral annular calcification (MAC), but data on the relationship between atherogenic indices and MAC are lacking. We aimed to investigate a possible relationship between MAC and atherogenic indices. Methods: In total 741 patients (n = 427 with MAC and n =314 without MAC) who were examined in our cardiology clinic from February 2016 to October 2021 were recruited in the study. Mitral annular calcification was diagnosed by transthoracic 2-dimensional echocardiography. The atherogenic coefficient (AC), Castelli risk indices 1 (CRI-1), Castelli risk indices 2 (CRI-2) and atherogenic index of plasma (AIP) were calculated by utilizing standard lipid test values. Results: There was no statistically significant difference in sex, age diabetes and hypertension status between the patient and the control groups. Serum triglyceride level, AIP, Hs-CRP, smoking and BMI were independently significantly associated with MAC in multiple regression analysis (p<0.001). Conclusion: Higher AIP was related to the existence of MAC and also predict the presence of MAC independently. Works assessing modification of those indices are needed.

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