Correlation Analysis Between Atherogenic Index Of Plasma,Carotid Intima-media Thickness And Coronary Heart Disease

Background and objective: In recent years, the morbidity and mortality of coronary heart disease(CHD) in China showed a rising trend year by year, and CHD has become one of the major threats to the life and health of urban and rural residents. Coronary angiography(CAG) was considered as “the gold standard” in the diagnosis of CHD, but the popularity of such examination technology was subjected to certain restrictions in asymptomatic patients and the general population due to invasive characteristic and related risk. Therefore, it was of great significance to find an alternative examination method simple to operate, good in repeatability and non-invasive for the early prediction of CHD. Atherosclerosis(AS) was the main pathological basis of CHD, and the intima of a blood vessel wall was the earliest affected area in the process of occurrence and development of AS, which was mainly manifested as intima-media thickening at the early stage. Carotid artery, a peripheral blood vessel, was considered as an important “bridge” to connect the heart and the brain, and shared similar pathogenic factors and pathogenesis in the occurrence and development of AS, thus making it possible to use the detection of AS in the carotid artery to indirectly reflect the severity of CHD. Furthermore, the disorder of lipid metabolism was one of the important risk factors of CHD and AS. Therefore, the present study aimed to investigate the correlation of carotid carotid intima-media thickness(IMT), atherogenic index of plasma(AIP) and CHD, and to assess the potential value of the above methods for the prediction of CHD by calculating AIP through the blood lipid, measuring the carotid IMT and combing the obtained CAG results through the combination of commonly used clinical biochemical tests including blood lipid and carotid artery ultrasonography.Materials and Methods: From January 2015 to January 2016, 197 patients hospitalized in the Department of Cardiovascular Internal Medicine of our hospital were selected.The general clinical data, blood lipid, carotid artery ultrasonography results and CAG results were collected for retrospective analysis. The blood lipid and carotid artery ultrasonography results were analyzed, and the AIP and carotid IMT values were calculated. According to the CAG results, all selected subjects(n = 197) were divided into CHD group(n = 108, 54.8%; male/female, 83/25; mean age, 65.1 ± 8.6 years old) and non-CHD group(n = 89, 45.2%; male/female, 55/34; mean age, 62.2 ± 9.0 years old). In addition, patients in the CHD group were divided into three subgroups according to the number of diseased vessels: single-vessel lesion group(n = 51), double-vessel lesion group(n = 30) and triple-vessel lesion group(n = 27). The AIP, IMT and other indicators in each group were analyzed and compared.Results: 1. There were no significant differences in general clinical data including body mass index(BMI), systolic blood pressure(SBP), diastolic blood pressure(DBP) or the proportion of patients complicated with hypertension between the CHD group and the non-CHD group(all P > 0.05); while age, the ratio of male to female, patients complicated with diabetes and the ratio of smoking history were significantly higher in the CHD group than those in the non-CHD group(all P < 0.05); obviously higher plasma total cholesterol(TC), triglycerides(TG) and low density lipoprotein cholesterol(LDL-C) levels and significantly lower plasma high density lipoprotein cholesterol(HDL-C) levels were found in the CHD group compared with the non-CHD group(all P < 0.05). 2. AIP and IMT values in the CHD group were significantly higher than those in the non-CHD group(all P < 0.001). 3. AIP and IMT values in the CHD subgroups were significantly higher than those in the non-CHD group, and IMT and AIP values increased with the increase of the number of diseased coronary artery(all P < 0.05). 4. TG, TC, L-LDL, AIP and IMT were positively correlated with the number of diseased coronary artery(r = 0.283~0.856, P < 0.01), H-LDL was negatively correlated with the number of diseased coronary artery(r =-0.317, P < 0.001); and AIP value was positively correlated carotid IMT(r = 0.348, P < 0.001). Conclusion: 1. The AIP and carotid IMT were positively correlated with the severity of CHD. 2. The AIP calculated by blood lipid index and carotid IMT determined by ultrasonography could be used as important indexes for the prediction of CHD.