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Meta-Analysis
. 2025 Jan 22;24(1):35.
doi: 10.1186/s12933-025-02582-2.

Atherogenic index of plasma and coronary artery disease: a systematic review and meta-analysis of observational studies

Ramin Assempoor #  1 , Mohammad Shahabaddin Daneshvar #  1 , Aryan Taghvaei  1 , Alireza Sattari Abroy  1 , Amir Azimi  2 , John R Nelson  3 , Kaveh Hosseini  4   5
Affiliations
Meta-Analysis

Atherogenic index of plasma and coronary artery disease: a systematic review and meta-analysis of observational studies

Ramin Assempoor et al. Cardiovasc Diabetol. .

Abstract

Background: 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.

Methods: 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.

Results: 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).

Conclusions: 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.

Keywords: Atherogenic index of plasma; Coronary artery disease; Outcomes; Prognosis; Risk; Severity.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Forest plots showing the pooled result of meta-analysis of CAD risk
Fig. 2
Fig. 2
Forest plots showing the pooled result of meta-analysis of CAD severity in populations without established CAD
Fig. 3
Fig. 3
The pooled result of the incidence rate of the adverse outcomes in populations without established CAD
Fig. 4
Fig. 4
The pooled result of the incidence rate of the adverse outcomes in populations with established CAD
See this image and copyright information in PMC

References

    1. Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, et al. 2024 Heart Disease and Stroke statistics: a report of US and Global Data from the American Heart Association. Circulation. 2024;149(8):e347–913. - PubMed
    1. Dobiásová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apob-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001;34(7):583–8. - PubMed
    1. Mechanick JI, Farkouh ME, Newman JD, Garvey WT. Cardiometabolic-based chronic disease, adiposity and dysglycemia drivers: JACC state-of-the-art review. J Am Coll Cardiol. 2020;75(5):525–38. - PMC - PubMed
    1. Yin B, Wu Z, Xia Y, Xiao S, Chen L, Li Y. Non-linear association of atherogenic index of plasma with insulin resistance and type 2 diabetes: a cross-sectional study. Cardiovasc Diabetol. 2023;22(1):157. - PMC - PubMed
    1. Won KB, Kim HJ, Cho JH, Lee SY, Her AY, Kim BK, Joo HJ, Park Y, Chang K, Song YB, et al. Different association of atherogenic index of plasma with the risk of high platelet reactivity according to the presentation of acute myocardial infarction. Sci Rep. 2024;14(1):10894. - PMC - PubMed

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