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Comparison of Plasma Postprandial Versus Fasting Atherogenic Index in Predicting Contrast-Induced Nephropathy After

Muhammet Salih Ateş1, Erdoğan Sökmen1, Fikret Keleş1

  • 1Department of Cardiology, Ahi Evran University Faculty of Medicine, Kırsehir, Turkey.

Angiology
|December 27, 2025
PubMed

Insights

Postprandial atherogenic index of plasma (PAIP) better predicts contrast-induced nephropathy (CIN) in acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). PAIP offers superior predictive value over fasting AIP (FAIP) for CIN risk assessment.

Area of Science:

  • Cardiology
  • Nephrology
  • Clinical Biochemistry

Background:

  • Contrast-induced nephropathy (CIN) is a significant complication following percutaneous coronary intervention (PCI) in acute coronary syndrome (ACS) patients.
  • The atherogenic index of plasma (AIP), calculated as log [triglyceride/high-density lipoprotein cholesterol (HDL-C)], is associated with cardiovascular risk.
  • The comparative predictive value of postprandial AIP (PAIP) versus fasting AIP (FAIP) for CIN remains unclear.

Purpose of the Study:

  • To compare the predictive ability of PAIP and FAIP for the development of CIN in ACS patients undergoing PCI.
  • To evaluate the role of postprandial versus fasting lipid profiles in assessing CIN risk.

Main Methods:

  • A cohort of 882 ACS patients undergoing PCI was analyzed, divided into a fasting AIP (FAIP) group (n=512) and a postprandial AIP (PAIP) group (n=370).
  • Lipid panels were collected either in a fasting or postprandial state to determine FAIP and PAIP, respectively.
  • Statistical analyses, including logistic regression and receiver operating characteristic (ROC) curve analysis, were performed to assess CIN prediction.

Main Results:

  • CIN incidence was similar between groups (15.6% in FAIP vs. 16.2% in PAIP, P=.813).
  • Mean AIP was significantly higher in the PAIP group (0.643±0.264) compared to the FAIP group (0.493±0.262, P<.001).
  • AIP independently predicted CIN in both groups, with significantly stronger predictive power in the PAIP group (OR 46.57, P<.001) than the FAIP group (OR 6.33, P=.003). ROC analysis revealed a higher area under the curve (AUC) for PAIP (0.712) compared to FAIP (0.670, P<.001).

Conclusions:

  • Postprandial atherogenic index of plasma (PAIP) is a superior predictor of contrast-induced nephropathy (CIN) in ACS patients undergoing PCI compared to fasting AIP (FAIP).
  • These findings highlight the importance of assessing postprandial lipid profiles for CIN risk stratification in this patient population.

Keywords:
acute coronary syndromeatherogenic index of plasmacontrast-induced nephropathyfasting atherogenic indexpostprandial atherogenic index

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