Predictive Value Of Plasma Atherogenic Index Combined With Arterial Stiffness Index For Premature Coronary Artery Disease

Objective: To investigate the predictive value of atherogenic index of plasma(AIP)combined with arterial stiffness index for the development of premature coronary artery disease(PCAD),and to determine the value of AIP and arterial stiffness in assessing the severity of coronary artery disease in this group of patients.Methods: 336 patients who were hospitalized in The First Affiliated Hospital of Xinjiang Medical University for coronary angiography(CAG)due to suspected coronary artery disease with chest pain and were <55 years old in men and <65 years old in women were divided into 163 cases of premature coronary artery disease(PCAD)group according to CAG results,including92 cases(56.4%)of acute coronary syndrome and 71 cases(43.6%)of stable coronary artery disease,and control group there were 173 cases,which were further divided into129 cases in group A(0 points),126 cases in group B(1-14 points),and 81 cases in group C(>14 points)according to Gensini score.The general clinical data and relevant laboratory tests were statistically analyzed among the groups.Results:(1)The differences in BMI,male,history of smoking,history of alcohol consumption,hypertension,diabetes,fibrinogen,homocysteine,triglycerides,HDL,fasting glucose,glycated hemoglobin,Serum creatinine,AIP,and ba-PWV between the PCAD group and the control group were statistically significant(P<0.05),but there was no statistical differences in age、family history of premature coronary artery disease、total cholesterol、low density lipoprotein-cholesterol、ABI between the two groups(P>0.05).(2)Pearson correlation analysis showed positive correlations between AIP,ba-PWV,and Gensini score(r=0.251,0.295,respectively,all P<0.05),and negative correlations between HDL levels and Gensini score(r=-0.212,P<0.05),while there was no significant correlation between triglycerides,total cholesterol,low-density lipoprotein and ABI and Gensini score(P>0.05).(3)Multifactorial binary logistic regression analysis showed that AIP,ba-PWV,Hcy,history of smoking,history of alcohol consumption,and diabetes were all independent risk factors for PCAD(all P<0.05),except for history of smoking(OR =4.195,95% CI:1.920 to 9.167,P<0.001),AIP was more important than other traditional risk factors for PCAD(OR =3.00 95% CI:1.102 to 8.164,P=0.032).(4)The cut-off value of PCAD diagnosed by a AIP was 2.24,the area under the ROC curve was 0.659(95%CI:0.601～0.717),the sensitivity was 64.40% and the specificity was 61.80%;the cut-off value of PCAD diagnosed by ba-PWV was 1479.75 cm/s,the area under the ROC curve was 0.745(95% CI 0.692～0.798),the sensitivity was 62.00% and the specificity was82.10%;the area under the ROC curve plotted with a AIP combined with ba-PWV was0.780(95% CI 0.730-0.830),with a sensitivity and specificity of 70.60% and 77.50%,respectively.Conclusion:Both AIP and ba-PWV are independent predictors of PCAD,and when combined,they can improve the sensitivity of diagnosing PCAD,and both of them are positively correlated with the degree of coronary artery lesions.