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Is the atherogenic index of plasma a predictor for mortality in ischemic stroke patients?: a retrospective
Sefa Tatar1, Osman Serhat Tokgöz2, Ümmü Gülsüm Selvi3
1Professor, Department of Cardiology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Türkiye.
Insights
Lower atherogenic index of plasma (AIP) predicts short-term mortality in acute ischemic stroke (AIS) patients. This finding offers a valuable, non-invasive prognostic tool for clinicians managing AIS.
Area of Science:
- Cardiology
- Neurology
- Clinical Biochemistry
Background:
- The atherogenic index of plasma (AIP) is a lipid-based marker used for cardiovascular risk prediction.
- Acute ischemic stroke (AIS) is a leading cause of mortality and morbidity worldwide.
Purpose of the Study:
- To investigate the association between AIP and 1-month mortality in patients diagnosed with AIS.
- To evaluate AIP as a potential prognostic biomarker for short-term outcomes in AIS.
Main Methods:
- A retrospective study was conducted in Türkiye involving 530 AIS patients.
- Clinical, demographic, and laboratory data were collected within 24 hours of admission.
- One-month mortality was analyzed in relation to patient AIP levels.
Main Results:
- A lower mean AIP was significantly associated with higher 1-month mortality in AIS patients (P = 0.001).
- An AIP value of 0.291 demonstrated high sensitivity and specificity for predicting mortality (AUC = 0.829).
- Lower AIP (below 0.291) was identified as an independent predictor of mortality in AIS patients (HR 3.962).
Conclusions:
- Lower AIP is an independent predictor of short-term mortality in AIS patients.
- AIP offers a sensitive and specific prognostic tool, potentially surpassing traditional lipid parameters.
- This non-invasive and cost-effective marker can aid clinicians in managing AIS patients and mitigating adverse outcomes.
Background:
The atherogenic index of plasma (AIP), derived from the logarithmic transformation of the triglyceride to high-density lipoprotein cholesterol ratio, is frequently used to predict cardiovascular events.
Objective:
This study aimed to investigate the association between AIP and 1-month mortality in patients with acute ischemic stroke (AIS).
Design And Setting:
Retrospective study was conducted in Türkiye.
Methods:
In total, 530 AIS patients were enrolled in this study. Clinical, demographic, and laboratory characteristics were recorded within 24 hours of admission. One-month mortality outcomes were analyzed in relation to the AIP of the patients.
Results:
Of the 530 patients, 140 patients did not survive during the follow-up period. The mean AIP was 0.50 ± 0.33 in survivors and 0.11 ± 0.27 in the mortality group (P = 0.001). In the receiver operating characteristic analysis, the AIP value of 0.291 had a sensitivity of 74.4%, specificity of 76.4%, positive predictive value of 75.92%, and negative predictive value of 74.9% for mortality. The AIP value above 0.291 had an AUC (area under curve) of 0.829 (95% CI [confidence interval] 0.78-0.88, P = 0.0001). In Cox regression analysis, AIP values below 0.291 (HR 3.962; 95% CI 2.643-5.937) were identified as an independent predictor of mortality. Higher mortality rates were observed in patients with cryptogenic stroke and AIP below 0.291 after stratification by stroke TOAST (P = 0.003).
Conclusions:
Lower AIP is an independent predictor of short-term mortality in AIS patients, surpassing the sensitivity of traditional lipid parameters. This study provides a valuable prognostic tool for clinicians, offering a non-invasive and cost-effective test for a condition associated with substantial mortality and morbidity.
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