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Plasma Atherogenic Index Predicts Malignant Arrhythmias in Non-STElevation Myocardial Infarction

Alperen Taş1, Muhammet Salih Ateş1, Çağatay Tunca1

  • 1Department of Cardiology, Ahi Evran University Training and Research Hospital, Kırşehir, Türkiye.

The Eurasian Journal of Medicine
|June 27, 2026
PubMed

Insights

The plasma atherogenic index independently predicts malignant ventricular arrhythmias and short-term mortality in patients with non-ST-elevation myocardial infarction. This simple lipid marker can improve risk stratification for high-risk individuals.

Area of Science:

  • Cardiology
  • Biochemistry
  • Clinical Medicine

Background:

  • Malignant ventricular arrhythmias are significant complications of non-ST-elevation myocardial infarction (NSTEMI).
  • The plasma atherogenic index (PAI), calculated from triglycerides and HDL cholesterol, reflects atherogenic dyslipidemia but its predictive role in NSTEMI arrhythmias is not well-established.

Purpose of the Study:

  • To investigate whether the plasma atherogenic index independently predicts malignant ventricular arrhythmias in patients diagnosed with non-ST-elevation myocardial infarction.

Main Methods:

  • Retrospective analysis of 502 NSTEMI patients (January 2024 - January 2025).
  • Patients were stratified by arrhythmia occurrence and PAI tertiles.
  • Logistic and Cox regression models were used to identify independent predictors of arrhythmias and mortality, respectively. ROC and Kaplan-Meier analyses assessed performance and survival.

Main Results:

  • Malignant ventricular arrhythmias were observed in 9.4% of patients, with significantly higher PAI values compared to those without arrhythmias (0.48 ± 0.35 vs. 0.21 ± 0.29, P < .001).
  • Multivariable analysis identified PAI as an independent predictor of both arrhythmias and short-term mortality (HR 1.342, P = .006).
  • PAI demonstrated the highest discriminative value for arrhythmias (AUC 0.721) and mortality (AUC 0.709) with a cut-off of 0.32.

Conclusions:

  • An elevated plasma atherogenic index is an independent predictor of malignant arrhythmias and short-term mortality in NSTEMI patients.
  • As an accessible lipid marker, PAI may enhance risk stratification in high-risk NSTEMI populations.
Abstract

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