Predictive value of the atherogenic index of plasma for chronic total occlusion before coronary angiography

Background: The atherogenic index of plasma (AIP) is calculated by logarithmic transformation of the ratio of triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) concentrations. Although previous studies have demonstrated that the AIP is associated with coronary artery disease, its association with chronic total occlusion (CTO) requires elucidation.

Hypothesis: We hypothesized that the AIP would have diagnostic value in cases of CTO and could be used to predict adverse events.

Methods: This study involved 1131 inpatients who underwent coronary angiography. Data on demographic and clinical characteristics, coronary artery stenosis rated by the Gensini score, and clinical assessment by the Global Registry of Acute Coronary Events and thrombolysis in myocardial infarction (TIMI) scores were collected by cardiovascular doctors. Serum AIP values were evaluated by logarithmic transformation of the ratio of TG and HDL-C concentrations. The correlations of AIP values with clinical parameters were assessed, and receiver-operating characteristic curves were constructed for CTO diagnosis.

Results: Overall, 1131 inpatients were assigned to the CTO (n = 398) and control (n = 733) groups. Compared with the control group, the CTO group showed a significantly higher AIP (p < .05). The AIP was positively correlated with body mass index, the TIMI score, the Gensini score, and stent length and was effective for the diagnosis and risk assessment of patients with CTO. Multivariate logistic regression analyses revealed that the AIP was an independent risk factor for CTO. The findings suggest that the AIP could predict the presence of CTO and disease severity.