Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China.
Eur J Intern Med. 2024 Jul;125:111-119. doi: 10.1016/j.ejim.2024.03.024. Epub 2024 Mar 26.
The atherogenic index of plasma (AIP) is linked to lipid metabolism and has shown considerable prognostic value in cardiovascular disorders. However, its role in myocardial infarction with non-obstructive coronary arteries (MINOCA) has not been investigated. We assessed the relationship between AIP, the severity of coronary stenosis, and prognosis in MINOCA.
We included consecutive patients who were diagnosed with MINOCA. AIP was calculated using the base 10 logarithm of the ratio between the levels of TG and HDL-C. The patients were divided into four groups based on their AIP quartiles: Q1 (AIP<-0.145), Q2 (AIP≥-0.145and≤0.049), Q3 (AIP>0.049and≤0.253), and Q4 (AIP>0.253). All patients underwent follow-up for MACE.
The final analysis included 421 patients, with 188 having normal coronaries (0 stenosis) and 233 exhibiting non-obstructive coronary artery disease (CAD) (<50 % stenosis). In the multivariate logistic analysis, highest AIP (Q4) group was significantly associated with increased risk of non-obstructive CAD in MINOCA (OR,1.994;95 % CI:1.075-3.698; P = 0.029). During the follow-up period, MACE occurred in 22.8 % of MINOCA patients. Q4 group exhibited a significantly higher rate of MACE (P = 0.021). Furthermore, when both AIP and coronary stenosis status were considered, the results revealed individuals in the Q4 group with non-obstructive CAD had the highest risk of MACE (log-rank P = 0.027). The adjusted Cox analysis indicated that the Q4 group was associated with a 2.052-fold increase in the HR of MACE.
AIP exhibits a notable association with the incidence of MACE in MINOCA patients and serves as a substantial marker for non-obstructive CAD in this patient group.
血浆致动脉粥样硬化指数（AIP）与脂代谢有关，在心血管疾病中显示出相当大的预后价值。然而，它在非阻塞性冠状动脉心肌梗死（MINOCA）中的作用尚未得到研究。我们评估了 AIP 与冠状动脉狭窄严重程度和 MINOCA 预后之间的关系。
我们纳入了连续诊断为 MINOCA 的患者。AIP 通过 TG 和 HDL-C 比值的以 10 为底的对数计算。根据 AIP 四分位数将患者分为四组：Q1（AIP <-0.145）、Q2（AIP≥-0.145 且≤0.049）、Q3（AIP>0.049 且≤0.253）和 Q4（AIP>0.253）。所有患者均接受 MACE 的随访。
最终分析包括 421 例患者，其中 188 例冠状动脉正常（0 狭窄），233 例存在非阻塞性冠状动脉疾病（CAD）（<50%狭窄）。在多变量逻辑分析中，AIP 最高的（Q4）组与 MINOCA 中非阻塞性 CAD 的风险增加显著相关（OR，1.994；95%CI：1.075-3.698；P = 0.029）。在随访期间，MINOCA 患者中有 22.8%发生了 MACE。Q4 组的 MACE 发生率显著较高（P = 0.021）。此外，当同时考虑 AIP 和冠状动脉狭窄状态时，结果显示 Q4 组中患有非阻塞性 CAD 的患者发生 MACE 的风险最高（对数秩检验 P = 0.027）。校正 Cox 分析表明，Q4 组的 MACE 风险比 HR 增加了 2.052 倍。
AIP 与 MINOCA 患者的 MACE 发生率显著相关，是该患者群体中非阻塞性 CAD 的重要标志物。
