Association Between Atherogenic Index of Plasma and Atherogenic Coefficient and in-Stent Restenosis After Drug-eluting Stent Implantation for Stable Coronary Artery Disease

Abstract

Introduction:Despite improvements in stent science, in-stent restenosis (ISR) remains a major problem. This study was designed to evaluate the atherogenic index of plasma (AIP) and atherogenic coefficient (AC) levels and their predictive values in patients who developed ISR after drug-eluting stent implantation for stable coronary artery disease.Methods:One hundred ninety-nine patients with ISR and 377 without ISR were included in the study. The biochemical and hematological parameters of the patients were measured. The AIP and AC values were calculated.Results:Patients with ISR had significantly longer stent length, lower stent diameter, lower ejection fraction, and higher SYNTAX score. They also had significantly higher levels of low-density lipoprotein cholesterol (LDL-C), triglyceride (TG), total cholesterol, AIP, and AC compared to that of patients who did not develop ISR. AIP had a sensitivity of 61.3% and specificity of 72.1% for predicting ISR a cut-off value of 0.58. AC had sensitivity and specificity of 69.8% and 58.8%, respectively, for the presence of ISR a cut-off value of 3.44. LDL-C level of 111.5 mg/dL had sensitivity and specificity of 65.3% and 54% for developing ISR, respectively. Paired comparisons of area difference under the receiver operating characteristic curve showed that AIP and AC had significantly greater area compared with that of LDL-C. Stent diameter, stent length, SYNTAX score, ejection fraction, AIP, and AC were the predictors of ISR.Conclusion:AIP and AC had higher specificities compared with that of LDL-C in predicting ISR. The calculation of AIP and AC is simple and could be used easily in clinical practice.

Keywords

• atherogenic index of plasma
• atherogenic coefficient
• in-stent restenosis