ATHEROGENIC INDEX OF PLASMA IS A MARKER OF PLAQUE VULNERABILITY IN CORONARY ARTERY DISEASE

Abstract

SESSION TITLE: Cardiovascular Disease Outcomes SESSION TYPE: Original Investigations PRESENTED ON: 10/09/2018 10:45 AM - 11:45 AM PURPOSE: Atherogenic index of plasma (AIP) is defined as the logarithmic ratio of molar concentrations of triglyceride & high-density lipoprotein. AIP correlates closely with the LDL particle size. Atherosclerosis is a systemic, lipid-driven immune-inflammatory state. We used AIP & neutrophil-lymphocyte ratio (NLR) as surrogate markers of plasma atherogenicity & inflammation. In this study, we sought to determine if AIP & NLR can reflect the lipid-driven inflammatory state in acute coronary syndrome. METHODS: A retrospective chart review of 390 patients who underwent cardiac catheterization from January to March 2016 was done. 77 patients with prior history of PCI & CABG were excluded. Patients were divided into acute coronary syndrome (ACS) & non-ACS group based on the indication for cardiac catheterization. ACS group was regarded as study group & non-ACS group was regarded as the control group. Data pertaining to demographics, lipid profile including total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL) & low-density lipoprotein (LDL) were recorded. AIP was calculated using log (TG/HDL) ratio. Neutrophil: Lymphocyte ratio (NLR) was calculated using simple arithmetic ratio. All the variables were compared in between the study & control groups. Results in the two groups were statistically tested using the chi-squared test. RESULTS: A total of 313 patients mean age (62.98 ± 11.54 years, 54% male & 46% female) were included in the study. 189 patients were categorized in the ACS group & 124 patients in the non-ACS group. Distribution of risk factors was similar in both groups. Mean age (p=0.13) was 63.64 ± 12.63 & 62.24 ±12.79 in non-ACS & ACS groups. TC: HDL ratio (p=0.07) was higher in ACS group; 3.64 ± 0.37 compared to 3.46 ± 0.49 in non-ACS group. Atherogenic Index of plasma (AIP); (p=0.01) was high in ACS group measuring 0.39 ± 0.03 compared to 0.35 ± 0.02 in non-ACS group. Neutrophil-lymphocyte ratio (NLR); (p=0.02) measured 2.81 ± 0.23 in ACS group compared to 2.55 ± 0.19 in the non-ACS group. CONCLUSIONS: High AIP & NLR potentially reflects the lipid-driven inflammatory state in acute coronary syndrome. This also suggests lipid-driven inflammatory process as a possible mechanism for plaque vulnerability. AIP can be easily calculated from the standard lipid profile & it can potentially add predictive value for future cardiovascular risk. Atherogenic index of plasma can be used as a target for lipid-lowering therapy beyond individual lipoprotein and/or TC: HDL ratio. CLINICAL IMPLICATIONS: Atherogenic index of plasma can potentially serve as a marker for high-risk atherosclerotic coronary artery disease. It can be used as a target for lipid-lowering therapy beyond individual lipoprotein and/or TC: HDL ratio. DISCLOSURES: No relevant relationships by Soney Basnyat, source=Web Response No relevant relationships by Surjeet Dheer, source=Web Response No relevant relationships by Reshma Golamari, source=Web Response No relevant relationships by Sonul Gulati, source=Web Response no disclosure on file for Ajay Koirala; no disclosure on file for Prasad Konda; no disclosure on file for Paritosh Prasai; No relevant relationships by Munis Raza, source=Web Response No relevant relationships by Yub Raj Sedhai, source=Web Response No relevant relationships by Subtain Zia, source=Web Response