The Comparison of the Associations of Lipoprotein(a) and the Atherogenic Index of Plasma With Coronary Artery Calcification in Patients Without High LDL-C: A Comparative Analysis

Abstract

Objective Lipoprotein(a) (Lp[a]) and the atherogenic index of plasma (AIP) have been reported as predictive markers of coronary artery calcium (CAC). However, previous studies demonstrated that the cardiovascular risk associations with Lp(a) are attenuated in patients with low-density lipoprotein cholesterol (LDL-C) levels ≤135 mg/dL. However, few articles have identified the risk factors of CAC in patients without high LDL-C. Therefore, we performed this study to investigate the association of Lp(a) and AIP with CAC in patients with LDL-C levels ≤135 mg/dL. Methods This study included 625 lipid-lowering agent naive patients with LDL-C levels ≤135 mg/dL who underwent coronary computed tomographic angiography. We performed multivariate logistic regression analysis to evaluate the risk factors for a coronary artery calcium score (CACS) >0, CACS ≥400, and CAC ≥90th percentile. Results The mean age of the patients was 55.0±7.9 years and their mean LDL-C level was 94.7 ±23.3 mg/dL. Multivariate regression analysis showed that age, male sex, diabetes, hypertension, Lp(a), and AIP were independent predictors of CAS>0. Age, male sex, and diabetes were independent predictors of CACS≥400. Diabetes, hypertension, and AIP were independent predictors of CAC ≥90th percentile (all p <0.05). Unlike Lp(a), higher AIP tertiles were associated with significantly higher CAC percentiles and greater proportions of patients with CACS ≥400 and CAC ≥90th percentile. Conclusion In patients without high LDL-C, AIP could be a more reliable predictor of CAC than Lp(a).

Does the Prevalence of Subclinical Coronary Atherosclerosis Increase in Primary Hyperparathyroidism; Coronary Flow Reserve and Plasma Aterogenic Index in Patients with Primary Hyperparathyroidism

“…It was previously shown to have a prognostic value for cardiovascular events in different systemic diseases (6)(7)(8). Transthoracic echocardiography can be 2 used to measure CFR; it is preferred because of its high diagnostic accuracy, versatility, low cost, and especially not being exposed to radiation (9) Although conventional atherogenic lipid parameters are used to assess the risk of CAD, many extensive epidemiological studies revealed that novel lipid indices, such as the plasma atherogenic index (PAI), have better predictive value for atherosclerotic CAD risk assessment than conventional ones (10)(11)(12) PAI is a newly popular lipid index obtained by logarithmic conversion of triglyceride (TRG) / high-density lipoprotein cholesterol (HDL-C) ratio. Relevant literature host studies having shown that it is associated with atherosclerosis and subclinical coronary artery disease and may be a marker for cardiovascular mortality (13,14).…”