血浆致动脉粥样硬化指数是慢性完全闭塞病变患者慢性完全闭塞和冠状动脉侧支循环形成的预测指标。

The Atherogenic Index of Plasma is a Predictor for Chronic Total Occlusion and Coronary Collateral Circulation Formation in CTOs Patients.

作者信息

Li Ya, Feng Yujia, Zhong Ya, Li Shu, Lin Jiesheng, Fang Peng, Wan Jing, Zhao Min

机构信息

Department of Cardiology, Zhongnan Hospital of Wuhan University, 430071 Wuhan, Hubei, China.

Department of Geratology, Zhongnan Hospital of Wuhan University, 430071 Wuhan, Hubei, China.

出版信息

Rev Cardiovasc Med. 2023 Oct 23;24(10):305. doi: 10.31083/j.rcm2410305. eCollection 2023 Oct.

DOI:10.31083/j.rcm2410305

PMID:39077586

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11273106/

Abstract

BACKGROUND

The atherogenic index of plasma (AIP), determined by the logarithmic transformation of the ratio of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C), was found to be a marker of cardiovascular disease. We sought to investigate the correlation between the atherogenic AIP and coronary collateral circulation (CCC) formation in chronic total occlusive (CTOs) patients.

METHODS

This retrospective cohort study included 665 non-CTOs and 345 CTOs patients. CTOs were divided into 206 CCC poor formation patients and 139 CCC good formation patients according to the Cohen-Rentrop grade. Spearman correlation analysis was carried out to obtain the relationship between AIP and the Rentrop grade. We used multivariate logistic regression analysis to assess CTOs and CCC poor formation risk factors. Receiver operating characteristic (ROC) curves were used to determine the optimal threshold for AIP to predict CTOs and CCC poor formation. The predicted increment of AIP on CTOs and CCC poor formation was evaluated by calculating the Net Reclassification Index (NRI) and the Integrated Discriminant Index (IDI).

RESULTS

AIP in CTOs was significantly elevated compared to non-CTOs patients [(1.55 (1.02, 2.59)) (1.26 (0.82, 1.90)), 0.001] AIP in the CCC poor formation group was significantly higher than that in the CCC good formation group [(1.73 (1.12, 2.90)) (1.37 (0.84, 2.13)), = 0.002]. There was a negative correlation between AIP and the Rentrop grade (r = -0.145, = 0.007). The results of multivariate logistic regression revealed that AIP was an independent predictor of CTOs (OR = 4.371, 95% CI: 2.436-7.844, 0.001) and CCC poor formation (OR = 3.749, 95% CI: 1.628-8.635, = 0.002). In the ROC analysis, the area under the curve of AIP for identifying CTOs and CCC poor formation was 0.596 (OR = 3.680, 95% CI: 1.490-9.090, = 0.005) and 0.597 (95% CI: 0.535-0.658, = 0.002), respectively.

CONCLUSIONS

Contrary to previous research, we found that AIP is a moderate but not powerful indicator for detecting both CTO patients and poor CCC formation.

摘要

背景

血浆致动脉粥样硬化指数（AIP）通过甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-C）比值的对数转换来确定，被发现是心血管疾病的一个标志物。我们试图研究致动脉粥样硬化的AIP与慢性完全闭塞（CTO）患者冠状动脉侧支循环（CCC）形成之间的相关性。

方法

这项回顾性队列研究纳入了665例非CTO患者和345例CTO患者。根据Cohen-Rentrop分级，CTO患者被分为206例CCC形成不良患者和139例CCC形成良好患者。进行Spearman相关性分析以获得AIP与Rentrop分级之间的关系。我们使用多因素逻辑回归分析来评估CTO和CCC形成不良的危险因素。采用受试者工作特征（ROC）曲线来确定AIP预测CTO和CCC形成不良的最佳阈值。通过计算净重新分类指数（NRI）和综合判别指数（IDI）来评估AIP对CTO和CCC形成不良的预测增量。

结果

与非CTO患者相比，CTO患者的AIP显著升高[（1.55（1.02，2.59））（1.26（0.82，1.90））， = 0.001]。CCC形成不良组的AIP显著高于CCC形成良好组[（1.73（1.12，2.90））（1.37（0.84，2.13））， = 0.002]。AIP与Rentrop分级之间存在负相关（r = -0.145， = 0.007）。多因素逻辑回归结果显示，AIP是CTO（OR = 4.371，95%CI：2.436 - 7.844， = 0.001）和CCC形成不良（OR = 3.749，95%CI：1.628 - 8.635， = 0.002）的独立预测因子。在ROC分析中，AIP识别CTO和CCC形成不良的曲线下面积分别为0.596（OR = 3.680，95%CI：1.490 - 9.090， = 0.005）和0.597（95%CI：0.535 - 0.658， = 0.002）。