Association between the atherogenic index of plasma and major adverse cardiovascular events among non-diabetic hypertensive older adults

Abstract

Background Literature on the association between the atherogenic index of plasma (AIP) and the risk of major adverse cardiovascular events (MACEs) among non-diabetic hypertensive older adults is quite limited. Methods A post-hoc analysis of data obtained from the Systolic Blood Pressure Intervention Trial was performed. The predictive value of AIP on the risk of MACEs among non-diabetic hypertensive older adults was assessed to evaluate whether the benefit of intensive blood pressure (BP) control in preventing MACEs is consistent in different AIP subgroups. Results In this study, 9323 participants with AIP were included, out of which 561 (6.02%) had composite cardiovascular outcomes during a median of 3.22 years of follow-up. Patients in the highest AIP quartile had a significantly increased risk of the primary outcome. In the fully adjusted Model 3, the adjusted hazard ratios (HRs) of the primary outcome for participants in Q2, Q3, and Q4 of AIP were 1.32 (1.02, 1.72), 1.38 (1.05, 1.81), and 1.56 (1.17, 2.08) respectively. Consistently, the trend test for the association between AIP quartiles and the primary outcome showed that a higher AIP quartile was associated with a significantly higher risk of the primary outcome (adjusted HR (95%CI) in model 3:1.14 (1.04, 1.25), P = 0,004). However, within each AIP quartile, absolute event rates were lower in the intensive treatment group. No evidence was found for the interaction between intensive BP control and AIP for the risk of the primary outcome (P for interaction = 0.932). Conclusion This study found that elevated AIP was independently and positively associated with the risk of MACEs among non-diabetic hypertensive older adults. The benefits of intensive BP control in managing cardiovascular events were consistent in different AIP subgroups.

The association of atherogenic index of plasma with cardiovascular outcomes in patients with coronary artery disease: A systematic review and meta-analysis

“…Fu et al demonstrated that diabetic patients with MACE had higher values of AIP, introducing a novel MACE predictor for high-risk patients [ 10 ]. Similar results were observed in another study, including non-diabetic older adults with hypertension [ 11 ]. Nevertheless, no meta-analysis has been performed to reveal AIP’s prognostic effect in patients with CAD; therefore, we sought to determine the association between the levels of AIP and prognosis in patients with CAD.…”

Association Between Atherogenic Index of Plasma and Risk of Incident Major Adverse Cardiovascular Events

“…We assume that the potential role of AIP with the risk of MACEs may be overwhelmed in individuals with other coexisting risk factors who are otherwise prone to MACEs, e.g., older population and those with hypertension, and diabetes. [11][12][13] These findings imply that monitoring and controlling AIP may bring additional cardiovascular benefits even in participants free of traditional risk factors in clinical practice. It should be noted that lipidlowering therapy may affect the AIP levels, or the MACEs that occurred in the first 2 years of follow-up may result from underlying primary diseases instead of AIP effects.…”

“…12) A post-hoc analysis of the Systolic Blood Pressure Intervention Trial demonstrated that AIP was independently and positively associated with the risk of MACEs among nondiabetic hypertensive older adults. 13) Recently, a 15-year cohort study on healthy adults revealed the value of AIP in the prediction of developing cardiovascular events and their related mortality. 25) A large Korean cohort study also showed that ele-vated AIP was significantly associated with ASCVD incidence and mortality after adjusting for the traditional risk factors.…”

“…9) Recent studies have demonstrated a positive correlation with ASCVD risk in patients with diabetes [10][11][12] or those who are nondiabetic hypertensive older adults. 13) However, few studies have investigated the role of AIP in predicting the risk of major adverse cardiovascular events (MACEs) in the general population.…”