Ki-Bum Won1, Ran Heo2, Hyung-Bok Park3, Byoung Kwon Lee4, Fay Y Lin5, Martin Hadamitzky6, Yong-Jin Kim7, Ji Min Sung8, Edoardo Conte9, Daniele Andreini9, Gianluca Pontone9, Matthew J Budoff10, Ilan Gottlieb11, Eun Ju Chun12, Filippo Cademartiri13, Erica Maffei14, Hugo Marques15, Pedro de Araújo Gonçalves16, Jonathon A Leipsic17, Sang-Eun Lee18, Sanghoon Shin18, Jung Hyun Choi19, Renu Virmani20, Habib Samady21, Kavitha Chinnaiyan22, Daniel S Berman23, Jagat Narula24, Leslee J Shaw5, Jeroen J Bax25, James K Min5, Hyuk-Jae Chang26. 1. Department of Cardiology, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. 2. Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Hanyang University Seoul Hospital, Hanyang University College of Medicine, Seoul, South Korea. 3. Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Catholic Kwandong University International St. Mary's Hospital, Incheon, South Korea. 4. Department of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea. 5. Department of Radiology, New York-Presbyterian Hospital and Weill Cornell Medicine, New York, NY, USA. 6. Department of Radiology and Nuclear Medicine, German Heart Center Munich, Munich, Germany. 7. Division of Cardiology, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea. 8. Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. 9. Centro Cardiologico Monzino, IRCCS, Milan, Italy. 10. Department of Medicine, Lundquist Institute at Harbor UCLA Medical Center, Torrance, CA, USA. 11. Department of Radiology, Casa de Saude São Jose, Rio de Janeiro, Brazil. 12. Seoul National University Bundang Hospital, Sungnam, South Korea. 13. Cardiovascular Imaging Center, SDN IRCCS, Naples, Italy. 14. Department of Radiology, Area Vasta 1/ASUR Marche, Urbino, Italy. 15. UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal. 16. UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisboa, Portugal; Nova Medical School, Lisbon, Portugal. 17. Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada. 18. Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Department of Cardiology, Ewha Womans University Seoul Hospital, Seoul, South Korea. 19. Department of Cardiology, Pusan University Hospital, Busan, South Korea. 20. Department of Pathology, CVPath Institute, Gaithersburg, MD, USA. 21. Department of Cardiology, Emory University School of Medicine, Atlanta, GA, USA. 22. Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA. 23. Department of Imaging and Medicine, Cedars Sinai Medical Center, Los Angeles, CA, USA. 24. Icahn School of Medicine at Mount Sinai, Mount Sinai Heart, Zena and Michael A. Wiener Cardiovascular Institute, And Marie-Josée and Henry R. Kravis Center for Cardiovascular Health, New York, NY, USA. 25. Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands. 26. Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea; Yonsei-Cedars-Sinai Integrative Cardiovascular Imaging Research Center, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea. Electronic address: hjchang@yuhs.ac.
Abstract
BACKGROUND AND AIMS: The atherogenic index of plasma (AIP) has been suggested as a marker of plasma atherogenicity. This study aimed to assess the association between AIP and the rapid progression of coronary atherosclerosis using serial coronary computed tomography angiography (CCTA). METHODS: A total of 1488 adults (60.9 ± 9.2 years, 58.9% male) who underwent serial CCTA with a median inter-scan period of 3.4 years were included. AIP was defined as the base 10 logarithm of the ratio of the concentrations of triglyceride to high-density lipoprotein cholesterol. Rapid plaque progression (RPP) was defined as the change of percentage atheroma volume (PAV) ≥1.0%/year. All participants were divided into three groups based on AIP tertiles. RESULTS: Baseline total PAV (median [interquartile range (IQR)]) (%) (group I [lowest]: 1.91 [0.00, 6.21] vs. group II: 2.82 [0.27, 8.83] vs. group III [highest]: 2.70 [0.41, 7.50]), the annual change of total PAV (median [IQR]) (%/year) (group I: 0.27 [0.00, 0.81] vs. group II: 0.37 [0.04, 1.11] vs. group III: 0.45 [0.06, 1.25]), and the incidence of RPP (group I: 19.7% vs. group II: 27.3% vs. group III: 31.4%) were significantly different among AIP tertiles (all p < 0.05). In multiple logistic regression analysis, the risk of RPP was increased in group III (odds ratio: 1.52, 95% confidence interval: 1.02-2.26; p = 0.042) compared to group I after adjusting for clinical factors and baseline total PAV. CONCLUSIONS: Based on serial CCTA findings, AIP is an independent predictive marker for RPP beyond traditional risk factors.
BACKGROUND AND AIMS: The atherogenic index of plasma (AIP) has been suggested as a marker of plasma atherogenicity. This study aimed to assess the association between AIP and the rapid progression of coronary atherosclerosis using serial coronary computed tomography angiography (CCTA). METHODS: A total of 1488 adults (60.9 ± 9.2 years, 58.9% male) who underwent serial CCTA with a median inter-scan period of 3.4 years were included. AIP was defined as the base 10 logarithm of the ratio of the concentrations of triglyceride to high-density lipoprotein cholesterol. Rapid plaque progression (RPP) was defined as the change of percentage atheroma volume (PAV) ≥1.0%/year. All participants were divided into three groups based on AIP tertiles. RESULTS: Baseline total PAV (median [interquartile range (IQR)]) (%) (group I [lowest]: 1.91 [0.00, 6.21] vs. group II: 2.82 [0.27, 8.83] vs. group III [highest]: 2.70 [0.41, 7.50]), the annual change of total PAV (median [IQR]) (%/year) (group I: 0.27 [0.00, 0.81] vs. group II: 0.37 [0.04, 1.11] vs. group III: 0.45 [0.06, 1.25]), and the incidence of RPP (group I: 19.7% vs. group II: 27.3% vs. group III: 31.4%) were significantly different among AIP tertiles (all p < 0.05). In multiple logistic regression analysis, the risk of RPP was increased in group III (odds ratio: 1.52, 95% confidence interval: 1.02-2.26; p = 0.042) compared to group I after adjusting for clinical factors and baseline total PAV. CONCLUSIONS: Based on serial CCTA findings, AIP is an independent predictive marker for RPP beyond traditional risk factors.