Department of Cardiology, Affiliated Hospital of Jiangsu University, Zhenjiang, 212001, China.
Institue of Cardiovascular Diseases, Jiangsu University, Zhenjiang, 212001, China.
Lipids Health Dis. 2024 Aug 20;23(1):258. doi: 10.1186/s12944-024-02255-1.
Dyslipidemia and abnormal cholesterol metabolism are closely related to coronary artery calcification (CAC) and are also critical factors in cardiovascular disease death. In recent years, the atherogenic index of plasma (AIP) has been widely used to evaluate vascular sclerosis. This study aimed to investigate the potential association of AIP between CAC and major adverse cardiovascular events (MACEs).
This study included 1,121 participants whose CACs were measured by multislice spiral CT. Participants' CAC Agatston score, CAC mass, CAC volume, and number of vessels with CACs were assessed. AIP is defined as the base 10 logarithm of the ratio of triglyceride (TG) concentration to high-density lipoprotein-cholesterol (HDL-C) concentration. We investigated the multivariate-adjusted associations between AIP, CAC, and MACEs. The mediating role of the AIP in CAC and MACEs was subsequently discussed.
During a median follow-up of 31 months, 74 MACEs were identified. For each additional unit of log-converted CAC, the MACE risk increased by 48% (HR 1.48 [95% CI 1.32-1.65]). For each additional unit of the AIP (multiplied by 10), the MACEs risk increased by 19%. Causal mediation analysis revealed that the AIP played a partial mediating role between CAC (CAC Agatston score, CAC mass) and MACEs, and the mediating proportions were 8.16% and 16.5%, respectively. However, the mediating effect of CAC volume tended to be nonsignificant (P = 0.137).
An increased AIP can be a risk factor for CAC and MACEs. Biomarkers based on lipid ratios are a readily available and low-cost strategy for identifying MACEs and mediating the association between CAC and MACEs. These findings provide a new perspective on CAC treatment, early diagnosis, and prevention of MACEs.
血脂异常和胆固醇代谢异常与冠状动脉钙化（CAC）密切相关，也是心血管疾病死亡的关键因素。近年来，血浆致动脉粥样硬化指数（AIP）已被广泛用于评估血管硬化。本研究旨在探讨 AIP 与 CAC 和主要不良心血管事件（MACEs）之间的潜在关联。
本研究纳入了 1121 名经多层螺旋 CT 测量 CAC 的参与者。评估了参与者的 CAC 得分、CAC 质量、CAC 体积和有 CAC 的血管数量。AIP 定义为甘油三酯（TG）浓度与高密度脂蛋白胆固醇（HDL-C）浓度之比的以 10 为底的对数。我们调查了 AIP、CAC 和 MACEs 之间的多变量调整关联。随后讨论了 AIP 在 CAC 和 MACEs 中的中介作用。
在中位数为 31 个月的随访期间，确定了 74 例 MACEs。每增加一个单位的对数转换 CAC，MACE 风险增加 48%（HR 1.48[95%CI 1.32-1.65]）。AIP 每增加一个单位（乘以 10），MACEs 的风险增加 19%。因果中介分析显示，AIP 在 CAC（CAC 得分、CAC 质量）和 MACEs 之间发挥部分中介作用，中介比例分别为 8.16%和 16.5%。然而，CAC 体积的中介效应有趋于不显著的趋势（P=0.137）。
AIP 升高可作为 CAC 和 MACEs 的危险因素。基于脂质比值的生物标志物是识别 MACEs 和介导 CAC 与 MACEs 之间关联的一种简便、低成本的策略。这些发现为 CAC 治疗、早期诊断和预防 MACEs 提供了新视角。
