Atherogenic index of plasma predicts coronary artery disease severity and major adverse cardiac events in absence of conventional risk factors

Mangalesh, Sridhar; Yadav, Pravesh; Dudani, Sharmila; Mahesh, Nalin Kumar

doi:10.1097/mca.0000000000001166

Cited by 12 publications

(5 citation statements)

References 40 publications

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“…The CONUT score and the CFS best represented nutritional risk and frailty, respectively, and were independently significant in the final model. Other parameters signaling inflammation and dyslipidemia such as hsCRP, neutrophil-lymphocyte ratio, and TG/HDLc ratio were also significant, similar to results from previous studies [29][30][31]. Previous studies comparing different frailty and nutritional measures in various disease conditions also report the superiority of the CFS and CONUT score [32][33][34][35][36].…”

Section: Discussionsupporting

confidence: 87%

Combined nutritional and frailty screening improves assessment of short-term prognosis in older adults following percutaneous coronary intervention

Mangalesh¹,

Daniel²,

Dudani³

et al. 2023

Coronary Artery Disease

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Background Frailty and malnutrition are well-known factors influencing outcomes of myocardial infarction (MI) in older adults. Due to considerable overlap between both entities, whether the simultaneous assessment of frailty and nutrition adds nonredundant value to risk assessment is unknown. Methods We performed a prospective cohort study on 402 patients aged at least 65 years diagnosed with ST-elevation MI that underwent percutaneous coronary intervention. Nutritional status was assessed by Controlling Nutritional Status score (CONUT), Prognostic Nutritional Index, and Geriatric Nutritional Response Index. Frailty was assessed by Clinical Frailty Scale (CFS), Derby frailty index, and acute frailty network. Primary outcome was major adverse cardiac events (MACE), comprising all-cause mortality, non-fatal MI, and unplanned repeat revascularization during 28-day follow-up. Increment in Global Registry of Acute Coronary Events (GRACE) score performance following the addition of nutrition and frailty was assessed. Results The incidence of MACE was 8.02 (6.38–9.95) per 1000 person-days. The CONUT score and CFS were the best predictors of MACE and independent predictors in the multivariate Cox-regression models [hazard ratios, 2.80 (1.54–5.09) and 2.54 (1.50–4.29)]. CONUT score classified 151 (37.6%) patients as malnourished, and CFS classified 131 (32.6%) as frail. The addition of both CONUT and CFS to the GRACE score led to better model discrimination and calibration through improved c-statistic (+0.165) (P < 0.0001) and Akaike and Bayesian information criteria. Conclusion Combining CONUT and CFS provides nonredundant prognostic value despite their overlapping nature. Combined nutritional and frailty screening may improve risk prognostication in older adults following MI.

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Section: Discussionsupporting

confidence: 87%

Combined nutritional and frailty screening improves assessment of short-term prognosis in older adults following percutaneous coronary intervention

Mangalesh¹,

Daniel²,

Dudani³

et al. 2023

Coronary Artery Disease

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“…For instance, Mangalesh et.al. found that AIP values were highly associated with both MACE within 3 years and the severity of CAD among patients with established coronary artery disease detected via coronary computed tomography angiography [36]. Moreover, Balci et.…”

Section: Discussionmentioning

confidence: 94%

Atherogenic Index of Plasma Predicts Obstructive Coronary Artery Disease in Patients with Stable Angina Pectoris

Kurklu,

Tan,

Ozyuncu

et al. 2023

Diagnostics

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Aims: Chronic coronary syndrome is associated with several risk factors, such as dyslipidemia and hypertension. The atherogenic index of plasma (AIP) has been demonstrated to be a biochemical risk factor for coronary artery disease (CAD). This study aimed to determine whether the AIP is an effective parameter for estimating obstructive CAD. Methods and Results: A total of 345 patients (with a mean age of 62.2 ± 10.3; 63% male) who underwent coronary angiography were included in this study. Obstructive CAD is defined as having one or more vessels with a stenosis level of ≥50%. Depending on the presence of obstructive CAD, all patients were divided into two groups. The mean AIP value was found to be 0.538 ± 0.26 in the study group. The AIP values were significantly higher in the obstructive coronary artery group (AIP; 0.49 ± 0.26 vs. 0.58 ± 0.27, p = 0.002). According to a univariable analysis, AIP values were significantly associated with obstructive coronary artery disease [OR: 3.74 (CI 95% 1.62–8.64), p = 0.020]. The AIP was further adjusted for confounding risk factors in three multivariable analysis models and, all three models showed a significant association. According to an ROC analysis, 0.49 is the cut-off value for AIP, and a value above 0.49 indicates 50% coronary artpery stenosis. Conclusions: The AIP may be used in the assessment of cardiovascular risk for patients with stable angina pectoris, and it may also be used to estimate obstructive CAD.

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“…The TG/HDL-C ratio and the hsCRP/albumin ratio were also independent predictors, consistent with previous studies. 40,41 On comparing the predictive ability of SIIRI vs other variables, SIIRI demonstrated the highest area under the curve. The optimal cut-off of SIIRI was 4.3 × 10 5 to predict severe CAD, represented by a SYNTAX score >22.…”

Section: Discussionmentioning

confidence: 99%

Development of a Novel Inflammatory Index to Predict Coronary Artery Disease Severity in Patients With Acute Coronary Syndrome

Mangalesh¹,

Dudani²,

Mahesh

2023

Angiology

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The systemic immune-inflammation index (SII) and systemic inflammation response index (SIRI) have previously demonstrated predictive value in coronary artery disease (CAD). We developed on an expanded, novel systemic immune-inflammation response index (SIIRI), calculated as peripheral neutrophil × monocyte × platelet ÷ lymphocyte count. We assessed 240 patients with an acute coronary syndrome that subsequently underwent percutaneous coronary intervention. CAD severity was measured using the SYNTAX score. Laboratory measurements, including cell counts, were obtained on admission. On multivariate analysis, the SIIRI was an independent predictor of severe CAD with an adjusted odds ratio (OR) of 1.666 [1.376-2.017] per 105-unit increase. The SIIRI had the highest area under the receiver operator curve of .771 [.709-.833] compared to the SII, SIRI neutrophil-lymphocyte ratio, monocyte-lymphocyte ratio, and platelet-lymphocyte ratio. The optimal cut-off for SIIRI was 4.3 × 105, with sensitivity = 69.9% and specificity = 75.8%. Increment in model performance resulting from adding SIIRI versus other inflammatory indices was assessed using discrimination, calibration, and goodness-of-fit measures. When added to a baseline model, the SIIRI resulted in a significant increase in the c-statistic and significant net reclassification index (.808, P < .0001) and integrated discrimination index (.129, P < .0001), and a decrease in Akaike and Bayesian information criteria.

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Atherogenic index of plasma predicts coronary artery disease severity and major adverse cardiac events in absence of conventional risk factors

Cited by 12 publications

References 40 publications

Combined nutritional and frailty screening improves assessment of short-term prognosis in older adults following percutaneous coronary intervention

Combined nutritional and frailty screening improves assessment of short-term prognosis in older adults following percutaneous coronary intervention

Atherogenic Index of Plasma Predicts Obstructive Coronary Artery Disease in Patients with Stable Angina Pectoris

Development of a Novel Inflammatory Index to Predict Coronary Artery Disease Severity in Patients With Acute Coronary Syndrome

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