Association between Atherogenic Index of Plasma and Subclinical Cerebrovascular Emboli after Carotid Artery Stenting
Gökhan Demirci1, Emre Yılmaz2, Sencer Çamcı2
1University of Health Sciences, Istanbul Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Department of Cardiology, Istanbul, Türkiye.
Background:
Subclinical cerebrovascular embolic events can occur after carotid artery stenting (CAS) and increase morbidity. This study aimed to evaluate the predictive value of the atherogenic index of plasma (AIP), a known atherosclerosis risk factor, for detecting such embolic events via diffusion-weighted imaging (DWI).
Methods:
Patients who underwent CAS between January 2018 and January 2023 and had DWI scans within 48 hours before and after the procedure were included. The relationship between AIP levels and new DWI lesions was analyzed.
Results:
The study included 123 patients (mean age 69.8 ± 6.5 years; 73.2% male). High AIP levels predicted the presence of DWI lesions with 82.4% sensitivity and 74.2% specificity (area under the curve: 0.780, P < 0.001). DWI lesions were significantly more common in the high AIP group (54.9%) compared to the low AIP group (8.3%) (P < 0.001). High AIP was associated with an odds ratio of 13.44 and a relative risk of 6.61 for lesion development. Older age [hazard ratio (HR): 1.288, 95% CI: 1.120-1.480, P < 0.001] and high AIP (HR: 18.421, 95% CI: 4.756-71.345, P < 0.001) were identified as independent predictors of DWI lesion development.
Conclusion:
A high AIP index is a strong and independent predictor of subclinical cerebrovascular emboli following CAS, as indicated by new DWI lesions.
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