The relationship between atherogenic index of plasma and plaque vulnerabilities: an optical coherence tomography study.

Background: Atherogenic index of plasma (AIP) has been recommended as a marker of plasma atherogenicity. The impact of AIP on plaque characteristics is not fully understood.

Purpose: The study investigates the relationship between AIP and coronary plaque features in patients with acute coronary syndrome (ACS).

Methods: From January 2016 to June 2017 pre-intervention optical coherence tomography (OCT) was performed in 522 ACS patients. AIP was defined as the base 10 logarithm of the ratio of the concentrations of triglyceride to high-density lipoprotein cholesterol. Patients were divided into four groups according to AIP quartiles.

Results: A total of 332 patients were included for the analysis. The prevalence of thin-cap fibroatheroma (TCFA) (group I [lowest] 9.09% vs group II 16.5% vs group III 44.7% vs group IV [highest] 52.9%), macrophage accumulation (group I 18.2% vs group II 22.4% vs group III 31.8% vs group IV 47.1%), plaque rupture (group I 10.4% vs group II 14.1% vs group III 17.6% vs group IV 34.1%) and plaque erosion (group I 2.6% vs group II 2.4% vs group III 14.1% vs group IV 12.9%) were significantly different among AIP quartiles. Multivariate logistic regression revealed the risk of TCFA (odds ratio 11.130, 95% confidence interval 4.186-29.593, p < 0.001) and plaque rupture (OR 5.332, 95% CI 2.040-13.937, p < 0.001) increased in group IV compared to group I. Receiver operating characteristics curve showed the predictive value of AIP for TCFA and plaque rupture were 0.720 and 0.669 respectively.

Conclusion(s): AIP is an independent predictor for vulnerable plaques beyond traditional factors. It can be integrated in clinical practice for risk stratification of ACS patients.

Trial Registration: All patients gave their consent to participate in the study and the Ethics Committee of Beijing Anzhen Hospital, Capital Medical University approved it (2020047X).