A Cross-sectional Study of Atherogenic Index of Plasma and Angiographic Profile by Gensini Score in Patients of Acute Coronary Syndrome

Abstract

Introduction: Coronary Artery Disease (CAD) is the leading cause of death worldwide. India has the highest burden of Acute Coronary Syndrome (ACS). Atherogenesis is a multifactorial process, abnormalities in lipoprotein metabolism especially elevated Low Density Lipoprotein Cholesterol (LDLc) remains one of most attributing key factor. Atherogenic Index of Plasma (AIP), can be calculated easily from the formula AIP=Log 10 Triglyceride (TG)/High Density Lipoprotein Cholesterol (HDLc). The AIP is inversely proportional to the diameter of LDLc particles, which indirectly reflects Small Dense LDLc levels. AIP has been proposed as a marker for Cardiovascular (CV) risk. Aim: The study aimed to assess the correlation between AIP and the Angiographic Profile by Gensini Score (GS) in ACS patients and also to evaluate the relationship between AIP and in-hospital mortality of ACS patients. Materials and Methods: This study was a hospital based cross- sectional study. This study was done from November 2019 to October 2020 in the Department of Cardiology, Sriram Chandra Bhanja Medical College, Odisha, India. A total of 240 patients of ACS were included in the study. AIP was calculated from the lipid profile of all the ACS patients. Coronary Angiography was done in all of these patients. Correlation of the AIP was done with the severity of CAD according to Gensini scoring system. Chi-square test was used to compare continuous variables p<0.05 was considered significant. Spearman’s rho correlation was also used to compare AIP with GS. Statistical analysis was performed using Statistical Package for the Social Sciences, (SPSS) 26 (IBM). Results: Majority of the cases were males 194 (80.8%) and females were 46 (19.2%). The Spearmans rho coefficient between AIP and GS was 0.663. It was statistically significant (p<0.001). AIP had positive correlation (value) with severity of CAD by GS. In-hospital mortality was 5%. It was more in high risk AIP group with a p-value of 0.006 which was statistically significant. Conclusion: AIP shows positive correlation with the severity of CAD in terms of GS. High AIP is also associated with increased in-hospital mortality. AIP can be used in the treatment of ACS patients and is a suitable alternative to various costly biomarkers of CAD. Therefore, AIP can be advocated for routine measurement in clinical practice.