Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, South Korea.
Atherosclerosis. 2021 May;324:46-51. doi: 10.1016/j.atherosclerosis.2021.03.009. Epub 2021 Mar 13.
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).
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.
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.
Based on serial CCTA findings, AIP is an independent predictive marker for RPP beyond traditional risk factors.
血浆致动脉粥样硬化指数（AIP）已被认为是血浆致动脉粥样硬化性的标志物。本研究旨在通过连续冠状动脉 CT 血管造影（CCTA）评估 AIP 与冠状动脉粥样硬化快速进展之间的关系。
共纳入 1488 名成年人（60.9±9.2 岁，58.9%为男性），中位随访时间为 3.4 年，均接受连续 CCTA。AIP 定义为甘油三酯与高密度脂蛋白胆固醇浓度比值的 base 10 对数。快速斑块进展（RPP）定义为斑块体积百分比变化（PAV）≥1.0%/年。所有参与者根据 AIP 三分位值分为三组。
基线总 PAV（中位数[四分位间距（IQR）]）（%）（第 1 组[最低]：1.91[0.00，6.21] vs. 第 2 组：2.82[0.27，8.83] vs. 第 3 组[最高]：2.70[0.41，7.50]），总 PAV 的年变化率（中位数[IQR]）（%/年）（第 1 组：0.27[0.00，0.81] vs. 第 2 组：0.37[0.04，1.11] vs. 第 3 组：0.45[0.06，1.25]）和 RPP 的发生率（第 1 组：19.7% vs. 第 2 组：27.3% vs. 第 3 组：31.4%）在 AIP 三分位组间差异有统计学意义（均 p<0.05）。在多因素 logistic 回归分析中，在校正临床因素和基线总 PAV 后，与第 1 组相比，第 3 组的 RPP 风险增加（比值比：1.52，95%置信区间：1.02-2.26；p=0.042）。
基于连续 CCTA 结果，AIP 是传统危险因素之外预测 RPP 的独立标志物。
