Atherogenic index of plasma and the risk of rapid progression of coronary atherosclerosis beyond traditional risk factors
Authors
Ki-Bum Won ; Ran Heo ; Hyung-Bok Park ; Byoung Kwon Lee ; Fay Y Lin ; Martin Hadamitzky ; Yong-Jin Kim ; Ji Min Sung ; Edoardo Conte ; Daniele Andreini ; Gianluca Pontone ; Matthew J Budoff ; Ilan Gottlieb ; Eun Ju Chun ; Filippo Cademartiri ; Erica Maffei ; Hugo Marques ; Pedro de Araújo Gonçalves ; Jonathon A Leipsic ; Sang-Eun Lee ; Sanghoon Shin ; Jung Hyun Choi ; Renu Virmani ; Habib Samady ; Kavitha Chinnaiyan ; Daniel S Berman ; Jagat Narula ; Leslee J Shaw ; Jeroen J Bax ; James K Min ; Hyuk-Jae Chang
Atherogenic index of plasma ; Atherosclerosis ; Coronary artery disease ; Coronary computed tomography angiography
Abstract
Background and aims: The atherogenic index of plasma (AIP) has been suggested as a marker of plasma atherogenicity. This study aimed to assess the association between AIP and the rapid progression of coronary atherosclerosis using serial coronary computed tomography angiography (CCTA).
Methods: A total of 1488 adults (60.9 ± 9.2 years, 58.9% male) who underwent serial CCTA with a median inter-scan period of 3.4 years were included. AIP was defined as the base 10 logarithm of the ratio of the concentrations of triglyceride to high-density lipoprotein cholesterol. Rapid plaque progression (RPP) was defined as the change of percentage atheroma volume (PAV) ≥1.0%/year. All participants were divided into three groups based on AIP tertiles.
Results: Baseline total PAV (median [interquartile range (IQR)]) (%) (group I [lowest]: 1.91 [0.00, 6.21] vs. group II: 2.82 [0.27, 8.83] vs. group III [highest]: 2.70 [0.41, 7.50]), the annual change of total PAV (median [IQR]) (%/year) (group I: 0.27 [0.00, 0.81] vs. group II: 0.37 [0.04, 1.11] vs. group III: 0.45 [0.06, 1.25]), and the incidence of RPP (group I: 19.7% vs. group II: 27.3% vs. group III: 31.4%) were significantly different among AIP tertiles (all p < 0.05). In multiple logistic regression analysis, the risk of RPP was increased in group III (odds ratio: 1.52, 95% confidence interval: 1.02-2.26; p = 0.042) compared to group I after adjusting for clinical factors and baseline total PAV.
Conclusions: Based on serial CCTA findings, AIP is an independent predictive marker for RPP beyond traditional risk factors.