Association between atherogenic index of plasma and in-hospital mortality in patients with STEMI undergoing primary percutaneous coronary intervention

Abstract

Aim: Dyslipidemia is an established risk factor for cardiovascular disease. Increased triglyceride (TG), low-density lipoprotein cholesterol (LDL-C) levels, and decreased high lipoprotein cholesterol (HDL-C) levels were associated with increased cardiovascular risk. Recently, comprehensive lipid profile indices derived from these conventional parameters have attracted to attention. Atherogenic index of plasma (AIP) is one of the indices calculated as the logarithm of TG/HDL-C levels and it is accepted as an alternative and simple marker of plasma atherogenicity. Although various studies demonstrated that their relationship with these lipid indices and clinical outcomes in patients with acute coronary syndrome, this situation is not yet clear in acute ST-elevation myocardial infarction (STEMI) patients undergoing primer percutaneous coronary intervention (pPCI). In this study, we aimed to investigate the relationship of AIP with early mortality in STEMI patients undergoing pPCI.Material and Method: This is a retrospective, single center, hospital-based study carried out between January 2019 and April 2021. A total of 873 consecutive STEMI patients (705 men; median age 59 years), whose undergoing pPCI, were enrolled. The patients were divided into two groups according to in-hospital mortality status namely survivors vs non-survivors. Conventional lipid values were measured and non-traditional lipid indexes including non-HDL-C [Total cholesterol minus HDL-C], Total cholesterol/HDL-C, LDL-C/HDL-C, atherogenic index (AI) [non-HDL-C/HDL-C], lipoprotein combine index (LCI) [Total cholesterol*TG*LDL-C/HDL-C] and atherogenic index of plasma (AIP) [Log(TG/HDL-C)] were calculated. Angiographic images of the patients were evaluated through the hospital automation system. Results: AIP was significantly higher in non-survivors compared to survivor group (0.59, 0.47, p=0.006, respectively). AI, non-HDL-C, Total cholesterol/HDL-C ratio, LDL-C/HDL-C ratio and LCI measurements were similar between two groups. The cut-off value of the AIP (0.50) was associated with 70% sensitivity and 52% specificity for predicts in-hospital mortality. Multivariate logistic regression model indicated AIP (OR: 3.77, 95% CI: 1.34–10.6, p < 0.012) as independent predictor of in-hospital mortality in STEMI patients undergoing pPCI. Conclusion: AIP predicts in-hospital mortality in patients with STEMI undergoing pPCI. AIP, which can be calculated easily by complete blood can be beneficial in evaluating the prognosis of these patients.