Atherogenic index of plasma as a predictor of the severity and anatomical complexity of coronary artery disease assessed by the SYNTAX i score

Abstract

Assessment of the severity and anatomical complexity of coronary artery disease (CAD) is crucial for therapeutic decision-mak ing and selecting patients for coronary revascularization. The aim of this study was to examine the association of basic lipid param eters (total cholesterol (TC), high/low density lipoprotein cholesterol (HDL-C, LDL-C), triglycerides (TG)), non-HDL-C, atherogenic index of plasma (AIP), TG-glucose index (TyG), Castelli risk index I and II (TC/HDL-C; LDL-C/HDL-C) with the anatomical severity of CAD, assessed by the SYNTAX I score in patients with stable angina pectoris (SAP). The study included 248 subjects with SAP from KBC “Zvezdara” and KBC “Dr Dragiša Mišović - Dedinje”. Based on coronary angi ography, patients were divided into two groups: lower (SYNTAX I≤22) and higher anatomical complexity (SYNTAX I>22). Lipid status parameters were determined using routine biochemical methods. AIP was calculated as the logarithmic ratio of TG and HDL-C; TyG index was calculated as a logarithmic function of the product of TG and glucose. In the SYNTAX I>22 group, there was a significantly higher prevalence of the male gender (p<0.001), more frequent use of statins and beta-blockers (p<0.001). HDL-C was significantly higher in the SYNTAX I≤22 group (p=0.011), while AIP and TyG were signifi cantly higher in the SYNTAX I>22 group (p=0.001). Other parameters showed no significant differences. By multivariate logistic regression, after adjusting for demographic factors and therapy, only AIP was confirmed as an independent predictor of SYNTAX I>22. AIP can serve as a useful, non-invasive biomarker for assessing the anatomical severity of CAD.