Atherogenic Index of Plasma and the Risk of In-Stent Restenosis in Patients with Acute Coronary Syndrome beyond the Traditional Risk Factors

• Published in: Journal of Atherosclerosis and Thrombosis 2022/08/01, Vol.29(8), pp.1226-1235
• Main Authors: Zhu, Yong, Chen, Maolin, Liu, Kesen, Gao, Ang, Kong, Xiangyun, Liu, Yan, Han, Hongya, Li, Hong, Zhu, Huagang, Zhang, Jianwei, Zhao, Yingxin
• Format: Article
• Language: English
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - complications; Acute Coronary Syndrome - etiology; Atherogenic index of plasma; Cholesterol, LDL; Coronary Angiography; Coronary Restenosis - diagnosis; Coronary Restenosis - etiology; Drug-eluting stent; Drug-Eluting Stents - adverse effects; Humans; In-stent restenosis; Low-density lipoprotein cholesterol; Original; Percutaneous Coronary Intervention; Retrospective Studies; Risk Factors; Treatment Outcome
• ISSN: 1340-3478; 1880-3873; 1880-3873
• DOI: 10.5551/jat.63136

Aim: Recently, the atherogenic index of plasma (AIP) has been proposed as a novel, reliable plasma atherogenicity marker. This study aimed to investigate the association of AIP with the risk of in-stent restenosis (ISR) in patients with acute coronary syndrome (ACS). Methods: This study retrospectively enrolled patients with ACS followed by angiography within 6 to 18 months after successful percutaneous coronary intervention (PCI) with a drug-eluting stent (DES). And the participants were divided into ISR or non-ISR groups based on the angiographic follow-up results. AIP was defined as the base 10 logarithm of the ratio of serum triglyceride (mmol/L) to high-density lipoprotein cholesterol (mmol/L).Results: This study recruited 1319 patients with ACS, 199 of which had ISR. Compared with the non-ISR group, patients in the ISR group had higher level of AIP (0.199±0.290 vs 0.131±0.282, p=0.002). In the multiple logistic regression analysis, AIP was an independent risk factor for DES-ISR (OR=2.100, 95% CI 1.134 to 3.891, p=0.018). When we modulated AIP as a categorical variable, the risk of DES-ISR increased in quartile 4 compared to quartile 1 (OR=1.713, 95% CI 1.040 to 2.822, p=0.034). Furthermore, this association remains stable in various subgroups. Unexpectedly, the subgroup analysis suggested AIP and DES-ISR had a stronger positive association in individuals with low-density lipoprotein cholesterol (LDL-C) ＜1.8 mmol/L.Conclusions: AIP and the risk of DES-ISR were positively and independently correlated in patients with ACS, especially in those with an LDL-C ＜1.8 mmol/L.