Atherogenic index of plasma and the risk of advanced subclinical coronary artery disease beyond traditional risk factors: An observational cohort study

Abstract

Background: Atherogenic lipoprotein profile of plasma is an important risk factor for atherosclerosis. The atherogenic index of plasma (AIP) has been suggested as a novel marker for atherosclerosis. Hypothesis: AIP is a useful marker of advanced subclinical coronary artery disease(CAD) in subjects without overt renal dysfunction. Methods: A total of 6928 subjects with estimated glomerular filtration rate > 60 mL/minutes/1.73 m2 evaluated by coronary computed tomography angiography (CCTA) for health check-up were included. The relation of AIP to advanced CAD (heavy coro-nary calcification, defined as coronary artery calcium score [CACS] >100 or obstruc-tive coronary plaque [OCP], defined as plaque with >50% stenosis) was evaluated. Results: All participants were stratified into four groups based on AIP quartiles. The prevalence of CACS >100 (group I [lowest] 4.7% vs group II 7.0% vs group III 8.8% vsgroup IV 10.0%) and OCP (group I 3.7% vs group II 6.4% vs group III 8.8% vs groupIV 10.9%) (allP< .001) increased with elevating AIP quartiles. Higher AIP (per 0.1 unitincrease) was associated with an increased risk of CACS >100 (odds ratio [OR] 1.057, 95% confidence interval (CI) 1.010 to 1.106,P= .017; relative risk (RR) 1.048, 95% CI1.009-1.089, andP= .015) and OCP (OR 1.079, 95% CI 1.033-1.127,P= .001; RR1.069, 95% CI 1.031-1.108,P< .001) after adjusting for age > 60 years, male sex,hypertension, diabetes mellitus, dyslipidaemia, obesity, and proteinuria. Conclusion: AIP is independently associated with advanced subclinical CAD beyondtraditional risk factors.