Low Plasma Atherogenic Index Associated with Poor Prognosis in Hospitalized Patients with Acute Myocardial Infarction
ABSTRACT: the impact of
atherogenic index of plasma (AIP), calculated as logarithmic of
triglyceride:HDL ratio (log10.[TG:HDL]), on major adverse cardiovascular events
(MACE) during acute myocardial infarction (AMI) has not been fully accepted.
This study aims to investigate the role of AIP in predicting major adverse cardiovascular
events following AMI during intensive care in the hospital. Methods: this was a
prospective cohort study. We enrolled subjects with AMI hospitalized in
intensive coronary care unit at Dr. Sardjito General Hospital, Yogyakarta. The
AIP was measured in fasting blood within 24 hours of hospital admission. The total
cholesterol, LDL, HDL, and triglyceride (TG), were measured and AIP value was
determined as log10. [TG:HDL]). Based on AIP value, subjects were allocated
into low AIP (<0.24) and high AIP (≥0.24). The outcome of the study was
major adverse cardiovascular events during hospitalization, i.e. multipart of
all cause mortality, acute heart failure, cardiogenic shock, reinfarction, and
rescucitated VT/VF. Results: among 277 subjects, the high AIP group comprised
213 subjects (77%) and low AIP group comprised 64 subjects (33%). During
intensive hospitalisation, 66 subjects (24%) developed MACE and 20 subjects
(7%) developed fatal outcome (all cause mortality). The incidence of MACE
tended to be higher in low AIP group, however its difference was not
signifcant. The incidence of all cause mortality was signifcantly higher in low
AIP group (14%) than in high AIP group (5%). Multivariable analysis showed that
low AIP predicted all cause mortality independently with a risk ratio 3.71 (95%
CI 1.26 – 10.97, p=0.02). Conclusion: low AIP value (<0.24) is an independent
predictor for all cause mortality in patients with acute myocardial infarction
undergoing intensive hospitalisation.
Keywords: atherogenic lipids,
atherogenic index of plasma, major adverse cardiovascular events, mortality
Author: Anggoro B. Hartopo,
Irsad A. Arso, Budi Y. Setianto
Journal Code: jpkedokterangg160009