Study Of The Relationships Between Atherogenic Index Of Plasma And The Progression Of Coronary Artery Lesions In The Elderly Patients After Percutaneous Coronary Intervention

Objective:To analyze the correlation between atherogenic index of plasma(AIP)and coronary lesion progression in elderly patients after coronary stent implantation and with low density lipoprotein cholesterol(LDL-C)compliance,and to explore the predictive value of AIP for coronary lesion progression in elderly patients with LDL-C compliance after stent implantation.Methods:A total of 125 elderly patients with coronary heart disease who were admitted to the department of cardiology,the Affiliated Hospital of Hangzhou Normal University from January 2017 to January 2020 and received drug-coated stent implantation for the first time and were reexamined 6 to 18 months after surgery with LDL-C <1.8mmol/l were selected;Gensini score was used to evaluate their degree of coronary lesion,and Gensini score progression rate was calculated.In accordance with Gensini score progression rate greater than or less than or equal to 1,the patients were divided into progression group and non-progression group;age,gender,smoking and drinking and other general conditions were compared between the two groups,and the correlation between AIP,LDL-C,triglyceride(TG),total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)with Gensini progression rate was analyzed in the meanwhile;risk factors for coronary lesion progression were evaluated by the two-category Logistic regression analysis,and predictive values of AIP and LDL-C in coronary lesion progression were further estimated and compared.Results:The levels of LDL-C,TG,AIP and the number of stent implants of patients in coronary lesion progression group were higher than those in non-progression group,while HDL-C levels were lower than those in non-progression group,which was statistically significant(P<0.05).AIP was positively correlated with LDL-C(r=0.344,P<0.01).After correction of mixed factors such as age,gender,BMI,glycated hemoglobin,serum creatinine,high-sensitivity C-reactive protein and total cholesterol,there was still a correlation(r=0.405,p<0.01).A Pearson or Spearman correlation analysis showed that AIP,LDL-C,TG,serum creatinine,number of stent implants were positively correlated with Gensini score progression rate,while HDL-C and ejection fraction were negatively correlated with Gensini progression rate.Logistic regression analysis on factors that might affect coronary lesion showed that AIP(OR=22.073,P<0.05),LDL-C(OR=8.601,P<0.05),TG(OR=2.175,P<0.05)and hypertension(OR=2.448,P<0.05)were independent risk factors for coronary lesion progression,and HDL-C was a protective factor(OR=0.018,P<0.05).The area under ROC curve(AUC)predicted by AIP for coronary lesion progression was 0.710(95%CI0.623-0.788,P<0.01),while AUC of LDL-C was 0.637(95% CI 0.546-0.721,P<0.01),there was no statistically significant difference between the two(P> 0.05);when AIP was 0.115,the value of predicting coronary lesion progression was the highest,with a sensitivity of 52.6% and a specificity of 79.6%.Conclusion:In elderly patients with coronary heart disease who received drug-coated stent implantation for the first time with LDL-C compliance,AIP level,as an independent risk factor for coronary lesion progression as well as a good indicator for predicting coronary lesion progression,was positively correlated with coronary Gensini progression;AIP might be a potential indicator for blood lipid monitoring in patients with coronary heart disease.