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血浆致动脉粥样硬化指数与慢性完全闭塞患者冠状动脉侧支循环的关系。

Association between the atherogenic index of plasma and coronary collateral circulation in patients with chronic total occlusion.

机构信息

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart Lung and Blood Vessel Disease, Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Beijing, 100029, China.

出版信息

BMC Cardiovasc Disord. 2024 Jul 16;24(1):360. doi: 10.1186/s12872-024-03992-y.

Abstract

BACKGROUND

The atherogenic index of plasma (AIP) is considered an independent risk factor for coronary artery disease (CAD). The present study investigated whether AIP correlates with the formation of coronary collateral circulation (CCC) in CAD patients with chronic total occlusion (CTO).

METHODS

This retrospective study included 1093 CAD patients with CTO confirmed by coronary angiography from January 2020 to December 2020 at Beijing Anzhen Hospital. Based on the Rentrop scoring system, the patients were divided into the good CCC group and the poor CCC group. AIP was calculated by log (triglyceride/high-density lipoprotein cholesterol). Meanwhile, the study population was further divided into four groups according to the quartiles of AIP.

RESULTS

Patients in the poor CCC group exhibited significantly higher AIP compared to those in the good CCC group (0.31 ± 0.27 vs. 0.14 ± 0.24, p < 0.001). Multivariate logistic regression analysis revealed an independent association between AIP and poor CCC, regardless of whether AIP was treated as a continuous or categorical variable (p < 0.001), after adjusting for confounding factors. Besides, this association remained consistent across most subgroups. The incorporation of AIP into the baseline model significantly enhanced the accuracy of identifying poor CCC [area under the curve (AUC): baseline model, 0.661 vs. baseline model + AIP, 0.721, p for comparison < 0.001].

CONCLUSIONS

Elevated AIP is independently associated with an increased risk of poor CCC in CAD patients with CTO, and AIP may improve the ability to identify poor CCC in clinical practice.

摘要

背景

血浆致动脉粥样硬化指数(AIP)被认为是冠心病(CAD)的独立危险因素。本研究旨在探讨 AIP 是否与 CAD 慢性完全闭塞(CTO)患者冠状动脉侧支循环(CCC)的形成相关。

方法

本回顾性研究纳入了 2020 年 1 月至 2020 年 12 月在北京安贞医院经冠状动脉造影证实为 CTO 的 1093 例 CAD 患者。根据 Rentrop 评分系统,将患者分为 CCC 良好组和 CCC 不良组。AIP 通过 log(甘油三酯/高密度脂蛋白胆固醇)计算。同时,根据 AIP 的四分位数将研究人群进一步分为四组。

结果

与 CCC 良好组相比,CCC 不良组患者的 AIP 显著升高(0.31±0.27 比 0.14±0.24,p<0.001)。多变量 logistic 回归分析显示,AIP 与 CCC 不良独立相关,无论 AIP 作为连续变量还是分类变量(p<0.001),在调整混杂因素后。此外,该相关性在大多数亚组中仍然一致。将 AIP 纳入基线模型显著提高了识别 CCC 不良的准确性[基线模型 AUC:0.661 比基线模型+AIP,0.721,p 比较<0.001]。

结论

AIP 升高与 CAD 患者 CTO 中 CCC 不良风险增加独立相关,AIP 可能提高临床实践中识别 CCC 不良的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3960/11251254/ac51f29760cb/12872_2024_3992_Fig1_HTML.jpg

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