Zhongguo quanke yixue (Feb 2023)
Predictive Value of Remnant Lipoprotein-cholesterol and Atherogenic Index of Plasma for First-time Acute Myocardial Infarction in Young Adults
Abstract
Background Acute myocardial infarction (AMI) can be found in some patients with normal serum lipids although abnormal lipid metabolism is a major risk of AMI. The association of AMI with two unconventional lipid parameters, namely residual lipoprotein-cholesterol (RLP-C) and atherogenic index of plasma (AIP), has been studied rarely, and the predictive value of RLP-C and AIP for first-time AMI in young adults still needs to be explored. Objective To assess the value of RLP-C and AIP in predicting first-time AMI in young adults. Methods A total of 1 201 inpatients aged 18-45 years old with an initial diagnosis of coronary heart disease (CHD) were selected from Northern Jiangsu People's Hospital from November 2014 to November 2021, including 627 with first-time AMI and 574 without. General demographics, triglyceride (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and other indicators were collected, and RPL-C and AIP were calculated according to the formula for statistical analysis. Logistic regression analysis was used to explore the influencing factors of first-time AMI. Receiver operating characteristic (ROC) analysis was used to evaluate the predictive value of RLP-C and AIP for first-time AMI. Results CHD patients with and without first-time AMI had significant differences in male ratio, smoking history, hypertension history, and average levels of TG, TC, HDL-C, LDL-C, RLP-C and AIP (P<0.05). Multivariate Logistic regression analysis showed that smoking history〔OR=2.541, 95%CI (1.824, 3.538) 〕, TC≥5.17 mmol/L〔OR=2.787, 95%CI (1.405, 5.531) 〕, RLP-C≥0.6 mmol/L〔OR=3.786, 95%CI (2.648, 5.413) 〕 and AIP≥0.2〔OR=3.427, 95%CI (2.106, 5.576) 〕independently increased the risk for first-time AMI (P<0.05), while HDL-C≥1.19 mmol/L〔OR=0.049, 95%CI (0.025, 0.093) 〕independently decreased the risk of first-time AMI (P<0.05). In ROC analysis, the performance of RLP-C and AIP predicting first-time AMI was as follows: RLP-C had an AUC of 0.851〔95%CI (0.830, 0.873) 〕, with 0.535 mmol/L as the optimal cut-off value, 0.848 sensitivity and 0.699 specificity; AIP had an AUC of 0.813〔95%CI (0.789, 0.837) 〕, with 0.122 as the optimal cut-off value, 0.852 sensitivity and 0.660 specificity. Conclusion The risk of first-time AMI in young adults may be increased by smoking history, TC≥5.17 mmol/L, RLP-C≥0.6 mmol/L and AIP≥0.2, and decreased by HDL-C≥1.19 mmol/L. RLP-C and AIP may partially predict first-time AMI.
Keywords
