Assempoor Ramin, Daneshvar Mohammad Shahabaddin, Taghvaei Aryan, Abroy Alireza Sattari, Azimi Amir, Nelson John R, Hosseini Kaveh
Cardiovascular Diseases Research Institute, Tehran Heart Center, Tehran University of Medical Sciences, North Kargar Ave, Tehran, 1995614331, Iran.
Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
Cardiovasc Diabetol. 2025 Jan 22;24(1):35. doi: 10.1186/s12933-025-02582-2.
Atherogenic index of plasma (AIP), a novel logarithmic index that combines fasting triglyceride and high-density lipoprotein cholesterol concentrations, is associated with the burden of atherosclerosis. This study aimed to evaluate the relationship between AIP and coronary artery disease (CAD) risk, severity, and prognosis in populations with and without established CAD.
PubMed, Embase, and Web of Science were systematically searched from the inception of each database to August 13, 2024. Cross-sectional studies, case-control studies, and prospective or retrospective cohort studies using multivariate analysis were included. Given that the true effect size may differ across studies, a random-effects model for all analyses was applied.
Fifty-one observational studies were included in this study. Patients with higher AIP were more likely to have CAD (odds ratio (OR): 2.79, 95% CI 1.75-4.45, P < 0.00001). Furthermore, these patients were more likely to have coronary artery calcification (OR: 2.28, 95% CI 1.74-3.00, P < 0.00001), multivessel CAD (OR: 2.04, 95% CI 1.50-2.77, P < 0.00001), and an increased risk of plaque progression (OR: 1.49, 95% CI 1.17-1.91, P = 0.001). In populations without established CAD, higher AIP levels were associated with an increased risk of Major adverse cardiovascular events (MACE) (hazard ratio (HR): 1.28, 95% CI 1.22-1.35, P < 0.00001). Interestingly, this finding was consistent in patients presenting with acute coronary syndrome (HR: 1.59, 95% CI 1.33-1.89, P < 0.00001) and patients with chronic coronary syndrome or stable CAD (HR: 1.65, 95% CI 1.15-2.37, P = 0.007).
This meta-analysis demonstrates that elevated AIP is strongly associated with increased CAD risk, greater severity, and poorer prognosis in populations with and without established CAD. However, more studies are needed to evaluate the predictive performance and determine the optimal cut-off for AIP in different populations.
血浆致动脉粥样硬化指数（AIP）是一种结合空腹甘油三酯和高密度脂蛋白胆固醇浓度的新型对数指数，与动脉粥样硬化负担相关。本研究旨在评估有和无确诊冠心病（CAD）人群中AIP与CAD风险、严重程度及预后之间的关系。
对PubMed、Embase和Web of Science从各数据库建库起至2024年8月13日进行系统检索。纳入使用多变量分析的横断面研究、病例对照研究以及前瞻性或回顾性队列研究。鉴于各研究的真实效应量可能不同，所有分析均采用随机效应模型。
本研究纳入了51项观察性研究。AIP较高的患者更易患CAD（优势比（OR）：2.79，95%置信区间1.75 - 4.45，P < 0.00001）。此外，这些患者更易出现冠状动脉钙化（OR：2.28，95%置信区间1.74 - 3.00，P < 0.00001）、多支血管CAD（OR：2.04，95%置信区间1.50 - 2.77，P < 0.00001），且斑块进展风险增加（OR：1.49，95%置信区间1.17 - 1.91，P = 0.001）。在无确诊CAD的人群中，较高的AIP水平与主要不良心血管事件（MACE）风险增加相关（风险比（HR）：1.28，95%置信区间1.22 - 1.35，P < 0.00001）。有趣的是，这一发现在急性冠状动脉综合征患者（HR：1.59，95%置信区间1.33 - 1.89，P < 0.00001）以及慢性冠状动脉综合征或稳定CAD患者中一致（HR：1.65，95%置信区间1.15 - 2.37，P = 0.007）。
这项荟萃分析表明，AIP升高与有和无确诊CAD人群中CAD风险增加、病情更严重及预后更差密切相关。然而，需要更多研究来评估AIP在不同人群中的预测性能并确定最佳临界值。
