Turk Kardiyol Dern Ars. Ahead of Print: TKDA-41820 | DOI: 10.5543/tkda.2025.41820

The Atherogenic Index of Plasma as a Novel Marker of Critical Multivessel Disease in Non-ST-Elevation Myocardial Infarction

Vedat Hekimsoy¹, Veysel Ozan Tanık¹, Kürşat Akbuğa¹, Alperen Taş², Ali Sezgin¹, Çağatay Tunca¹, Erhan Saraçoğlu¹, Bülent Özlek^3
1Department of Cardiology, Ankara Etlik City Hospital, Ankara, Türkiye
²Department of Cardiology, Kırşehir Training and Research Hospital, Kırşehir, Türkiye
³Department of Cardiology, Muğla Sıtkı Koçman University, School of Medicine, Muğla, Türkiye

OBJECTIVE
This study aimed to determine whether the atherogenic index of plasma (AIP) can predict critical multivessel coronary artery disease (MVD) in patients presenting with non–ST-segment elevation myocardial infarction (NSTEMI).

METHOD
In this retrospective analysis, patients diagnosed with NSTEMI who underwent coronary angiography between January and December 2024 were evaluated. Based on angiographic findings, patients were classified according to the number of major epicardial vessels with significant stenosis, and MVD was defined as critical involvement of all three major vessels. The AIP was calculated as log (triglyceride/HDL-cholesterol). Multivariable logistic regression analysis was applied to identify independent predictors of MVD, and ROC curve analysis was performed to assess diagnostic accuracy.

RESULTS
Of 1,216 patients included in the study, 302 (24.8%) had MVD. Those with critical MVD had significantly higher AIP values than those without MVD (0.74 ± 0.28 vs. 0.59 ± 0.26, p < 0.001). In multivariable analysis, AIP remained an independent determinant of MVD (odds ratio: 3.132, 95% confidence interval: 1.626–6.030, p = 0.001). Diabetes mellitus, higher HbA1c, and elevated LDL cholesterol levels were also independently associated with MVD. AIP showed moderate discriminative ability for predicting MVD, with an AUC of 0.689 and sensitivity and specificity of 65.6%.

CONCLUSION
AIP was independently associated with the presence of critical MVD in patients with NSTEMI. Given its simplicity, affordability, and accessibility, AIP may serve as a practical indicator of atherogenic burden and assist in identifying patients who are more likely to have multivessel coronary involvement.

Keywords: Acute coronary syndrome, atherogenic index of plasma,multivessel coronary artery disease, non-ST-segment elevation myocardial infarction, predictors

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