Zhou Yuanjun, Zhong Liping, Liao Yilin, Zhong Yuting
Department of Anaesthesiology, Meizhou People's Hospital, 63 Huangtang Road, Meijiang District, Meizhou, Guangdong, China.
BMC Cardiovasc Disord. 2025 Feb 3;25(1):75. doi: 10.1186/s12872-025-04534-w.
The atherogenic index of plasma (AIP) is a reliable lipid marker associated with coronary artery stenosis (CAS) and cardiovascular events. However, the relationship between AIP and myocardial injury after non-cardiac surgery (MINS) remains insufficiently explored.
This retrospective study included adult patients who underwent non-cardiac surgery under general anaesthesia. The primary exposure was preoperative AIP, with MINS as the primary outcome. The predictive accuracy of AIP for MINS was assessed using the area under the curve (AUC). Restricted cubic splines (RCS) were used to explore the potential nonlinear relationship between AIP and MINS. Logistic regression analysis was conducted to examine the association of AIP with MINS. Subgroup and interaction analyses were carried out across multiple factors, including age, gender, body mass index, medical history, and the type of surgery (emergency or elective).
The cohort consisted of 1,160 adult patients, with a median preoperative AIP of -0.05. The incidence of MINS was 7.9%. The AUC for AIP in predicting MINS was 0.719, surpassing the AUCs of triglycerides and high-density lipoprotein cholesterol (0.644 and 0.683, respectively). RCS analysis demonstrated a linear relationship between AIP and MINS (P for nonlinear = 0.165). Patients in the highest quartile of AIP had significantly higher odds of developing MINS than those in the lowest quartile (adjusted OR, 8.05; 95% confidence interval [CI], 3.44 to 18.80; P < 0.001). The results across most subgroups were consistent with the primary analysis, showing no significant interaction effects.
A significant and independent linear relationship exists between preoperative AIP and the risk of MINS. As an economical and easily accessible lipid marker, AIP holds potential for preoperative screening of patients at risk of postoperative cardiovascular events.
血浆致动脉粥样硬化指数（AIP）是一种与冠状动脉狭窄（CAS）和心血管事件相关的可靠脂质标志物。然而，AIP与非心脏手术后心肌损伤（MINS）之间的关系仍未得到充分研究。
这项回顾性研究纳入了接受全身麻醉下非心脏手术的成年患者。主要暴露因素是术前AIP，主要结局是MINS。使用曲线下面积（AUC）评估AIP对MINS的预测准确性。采用限制性立方样条（RCS）来探索AIP与MINS之间潜在的非线性关系。进行逻辑回归分析以检验AIP与MINS的关联。跨年龄、性别、体重指数、病史和手术类型（急诊或择期）等多个因素进行亚组分析和交互分析。
该队列包括1160名成年患者，术前AIP中位数为-0.05。MINS的发生率为7.9%。AIP预测MINS的AUC为0.719，超过了甘油三酯和高密度脂蛋白胆固醇的AUC（分别为0.644和0.683）。RCS分析表明AIP与MINS之间存在线性关系（非线性P=0.165）。AIP处于最高四分位数的患者发生MINS的几率显著高于最低四分位数的患者（调整后的OR，8.05；95%置信区间[CI]，3.44至18.80；P<0.001）。大多数亚组的结果与主要分析一致，未显示出显著的交互作用。
术前AIP与MINS风险之间存在显著且独立的线性关系。作为一种经济且易于获取的脂质标志物，AIP在术前筛查术后心血管事件风险患者方面具有潜力。
