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Abstract：
BACKGROUND: Atherogenic index of plasma (AIP) has been reported as a critical predictor on the risks and clinical outcomes of cardiovascular diseases (CVDs), and we aimed to explore the potential predictive value of cumulative AIP on major adverse cardiac events (MACE), stroke, myocardial infarction (MI) and cardiovascular mortality.
METHODS: A large-scale community-based prospective cohort was established from December 2011 to April 2012 and followed up in May to July 2014. The endpoint outcomes were obtained before December 31, 2021. AIP was calculated as the logarithmically transformed ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) and cumulative AIP was the average value of AIP in 2012 and 2014.
RESULTS: An overall of 3820 participants (36.1% male) with mean (SD) age of 59.1 (8.7) years, were enrolled. Within a median follow-up of 7.5 years, a total of 371 (9.7%) participants were documented with MACE, 293 (7.7%) participants developed stroke, 68 (1.8%) suffered from MI and 65 (1.7%) experienced cardiovascular mortality. Multivariable Cox regression analysis revealed significant associations between cumulative AIP and the risk of MACE, stroke and MI. Regarding MACE, individuals with one higher unit of cumulative AIP were associated with 75% increment on the incidence of going through MACE in fully adjusted model, while categorizing participants into four groups, individuals in the highest cumulative AIP quartile were significantly associated with increased incidence of MACE (HR = 1.76, 95%CI: 1.27-2.44, p < 0.001 in fully adjusted model), stroke (HR = 1.69, 95%CI: 1.17-2.45, p = 0.005) and MI (HR = 2.82, 95%CI: 1.18-6.72, p = 0.019). But not a significant association was observed between cumulative AIP and cardiovascular mortality. In subgroup analysis, the association of cumulative AIP and the incidence of stroke was more pronounced in the elderly (HR: 0.89 vs. 2.41 for the age groups < 65 years and ≥ 65 years, p for interaction = 0.018).
CONCLUSIONS: A higher cumulative AIP was significantly associated with an increased risk of MACE, stroke and MI independent of traditional cardiovascular risk factors in a community-based population, and the association of cumulative AIP and stroke was particularly pronounced in the elderly population.
METHODS: A large-scale community-based prospective cohort was established from December 2011 to April 2012 and followed up in May to July 2014. The endpoint outcomes were obtained before December 31, 2021. AIP was calculated as the logarithmically transformed ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-c) and cumulative AIP was the average value of AIP in 2012 and 2014.
RESULTS: An overall of 3820 participants (36.1% male) with mean (SD) age of 59.1 (8.7) years, were enrolled. Within a median follow-up of 7.5 years, a total of 371 (9.7%) participants were documented with MACE, 293 (7.7%) participants developed stroke, 68 (1.8%) suffered from MI and 65 (1.7%) experienced cardiovascular mortality. Multivariable Cox regression analysis revealed significant associations between cumulative AIP and the risk of MACE, stroke and MI. Regarding MACE, individuals with one higher unit of cumulative AIP were associated with 75% increment on the incidence of going through MACE in fully adjusted model, while categorizing participants into four groups, individuals in the highest cumulative AIP quartile were significantly associated with increased incidence of MACE (HR = 1.76, 95%CI: 1.27-2.44, p < 0.001 in fully adjusted model), stroke (HR = 1.69, 95%CI: 1.17-2.45, p = 0.005) and MI (HR = 2.82, 95%CI: 1.18-6.72, p = 0.019). But not a significant association was observed between cumulative AIP and cardiovascular mortality. In subgroup analysis, the association of cumulative AIP and the incidence of stroke was more pronounced in the elderly (HR: 0.89 vs. 2.41 for the age groups < 65 years and ≥ 65 years, p for interaction = 0.018).
CONCLUSIONS: A higher cumulative AIP was significantly associated with an increased risk of MACE, stroke and MI independent of traditional cardiovascular risk factors in a community-based population, and the association of cumulative AIP and stroke was particularly pronounced in the elderly population.
摘要：
背景：据报道，血浆致动脉粥样硬化指数（AIP）是心血管疾病（CVDs）风险和临床结果的关键预测因子，我们旨在探讨累积AIP对主要不良心脏事件（MACE）的潜在预测价值，中风,心肌梗死（MI）和心血管死亡率。
方法：从2011年12月至2012年4月建立了大规模的基于社区的前瞻性队列，并在2014年5月至7月进行了随访。终点结果是在2021年12月31日之前获得的。AIP计算为甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-c）的对数转换比，累积AIP为2012年和2014年AIP的平均值。
结果：总共3820名参与者（男性占36.1％），平均（SD）年龄为59.1（8.7）岁，已注册。在7.5年的中位随访时间内，共有371名(9.7%)参与者被记录为MACE，293名（7.7％）参与者出现中风，68（1.8％）患有MI，65（1.7％）经历心血管死亡。多变量Cox回归分析显示累积AIP与MACE风险之间存在显著关联，中风和MI。关于MACE,在完全调整模型中，具有较高累积AIP单位的个体与经历MACE的发生率增加75%相关，将参与者分为四组，最高累积AIP四分位数的个体与MACE的发生率显着相关（HR=1.76，95CI：1.27-2.44，完全校正模型中p<0.001），卒中(HR=1.69,95CI:1.17-2.45,p=0.005)和MI(HR=2.82,95CI:1.18-6.72,p=0.019)。但在累积AIP和心血管死亡率之间没有观察到显著关联。在亚组分析中，在老年人中，累积AIP与卒中发生率的关联更为明显（HR：0.89vs.<65岁和≥65岁年龄组为2.41，相互作用的p=0.018)。
结论：较高的累积AIP与MACE风险增加显著相关，在社区人群中，卒中和MI独立于传统的心血管危险因素，累积AIP与卒中的相关性在老年人群中尤为明显.
方法：从2011年12月至2012年4月建立了大规模的基于社区的前瞻性队列，并在2014年5月至7月进行了随访。终点结果是在2021年12月31日之前获得的。AIP计算为甘油三酯（TG）与高密度脂蛋白胆固醇（HDL-c）的对数转换比，累积AIP为2012年和2014年AIP的平均值。
结果：总共3820名参与者（男性占36.1％），平均（SD）年龄为59.1（8.7）岁，已注册。在7.5年的中位随访时间内，共有371名(9.7%)参与者被记录为MACE，293名（7.7％）参与者出现中风，68（1.8％）患有MI，65（1.7％）经历心血管死亡。多变量Cox回归分析显示累积AIP与MACE风险之间存在显著关联，中风和MI。关于MACE,在完全调整模型中，具有较高累积AIP单位的个体与经历MACE的发生率增加75%相关，将参与者分为四组，最高累积AIP四分位数的个体与MACE的发生率显着相关（HR=1.76，95CI：1.27-2.44，完全校正模型中p<0.001），卒中(HR=1.69,95CI:1.17-2.45,p=0.005)和MI(HR=2.82,95CI:1.18-6.72,p=0.019)。但在累积AIP和心血管死亡率之间没有观察到显著关联。在亚组分析中，在老年人中，累积AIP与卒中发生率的关联更为明显（HR：0.89vs.<65岁和≥65岁年龄组为2.41，相互作用的p=0.018)。
结论：较高的累积AIP与MACE风险增加显著相关，在社区人群中，卒中和MI独立于传统的心血管危险因素，累积AIP与卒中的相关性在老年人群中尤为明显.
