A Study Assessing the Correlation of Atherogenic Index of Plasma with Severity of Coronary Artery Disease by Modified Gensini Score in Postmenopausal Women

Abstract

ABSTRACT Introduction: The latest area of interest in lipids is small dense low-density lipoprotein cholesterol (sdLDL-C). They are highly atherogenic. There is no effective way of estimating them convetionally. Atherogenic index of plasma (AIP) reflects the level of sdLDL-C. The postmenopausal women have increased likelihood for coronary artery disease (CAD). In this study, the correlation between AIP and severity of CAD in postmenopausal women was assessed. Materials and Methods: A total of 448 postmenopausal women with chest pain were screened, of which 252 had a provisional diagnosis of CAD. Of them, 148 patients satisfying inclusion criteria were enrolled. Routine investigations, electrocardiogram, echocardiography, and coronary angiogram (CAG) were performed. Modified Gensini score (mGS) was used for severity of CAD. Chi-square test and Spearman correlation were used to analyze the correlation. Results: The mean age was 57 ± 8.3 years. The most common presentation was STEMI (32.4%), followed by unstable angina (28.4%). Patients already on statin therapy were 26.4%. Hypertension (HTN) was the most common risk factor (38.5%), followed by diabetes with HTN (23%). The mean AIP and mGS score were 0.23 ± 0.16 and 99.66 ± 65.61, respectively. Higher AIP values were seen in patients with higher mGS. Patients on statins and with normal lipid parameters showed higher mGS and AIP. There was a positive correlation of AIP with diabetes, HTN, Vitamin-D deficiency, C-reactive protein, body mass index, waist-circumference, waist-hip ratio, and waist-height ratio. Conclusion: AIP is a novel indicator and a strong marker for predicting the severity of CAD in postmenopausal women. In postmenopausal women with recurrent CAD and on statin therapy previously, AIP levels were high, implying that they need further management.