Research Article
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Atherogenic plasma index is associated with ischemıc cerebrovascular events due to carotid artery disease

Year 2024, Volume: 6 Issue: 3, 198 - 202, 28.05.2024
https://doi.org/10.38053/acmj.1448539

Abstract

Aims: Low molecular weight lipoprotein (LDL) and triglyceride (Tg), among cardiovascular disease risk factors, are replaced by markers with higher sensitivity and specificity. The atherogenic plasma index (API) has a strong predictive power for cardiovascular diseases. In our study, we aimed to compare the predictive power of API and other lipid parameters in detecting carotid artery disease (CAS) in patients with ischemic stroke.
Methods: A total of 878 individuals were analyzed, and 583 patients with ischemic stroke were enrolled in this study. The patients were divided into two groups according to the presence or absence of carotid artery disease in the Doppler ultrasound examination. Demographic data and lipid parameters were compared between both groups.
Results: The mean age of the patients with CAS was statistically significantly higher than the other group (74.33±11.27 vs 70.11±13.57; p=0.002). The Tg/HDL ratio was higher in patients with CAS than those without (3.80±2.83 vs 3.69±2.57; p=0.048). API was found to be statistically significantly higher in the group of patients with CAS compared to the other group (0.67±0.32 vs 0.48±0.25; p=0.024). Tg/HDL ratio and API were determined as predictive parameters for CAS in patients with ischemic cerebrovascular stroke. [OR: 1.345 (0.712-1.437); p=0.048, OR: 7.21 (0.881-8.056); p=0.023].
Conclusion: Conflicting results regarding the relation between atherosclerosis and conventional lipid parameters led to more specific subgroups being investigated. API shows a good correlation with the highly sensitive LDL subfraction in terms of atherosclerosis. API is a feasible variable predicting the presence of CAS in patients with ischemic stroke.

Ethical Statement

The study was initiated with the approval of the XXXXXXX University Medical Faculty Clinical Researches Ethics Committee (Date: 13/12/2022, Decision No: 62448).

References

  • Naylor AR, Ricco JB, de Borst GJ, et al. Editor’s choice-management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(1):3-81.
  • van Dam-Nolen DHK, Truijman MTB, van der Kolk AG, et al. Carotid plaque characteristics predict recurrent ischemic stroke and TIA: the PARISK (Plaque At RISK) study. Cardiovasc Imaging. 2022;15(10):1715-1726.
  • Yuan S, Tang B, Zheng J, Larsson SC. Circulating lipoprotein lipids, apolipoproteins and ischemic stroke. Ann Neurol. 2020;88(6):1229-1236.
  • Amarenco P, Labreuche J. Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol. 2009;8(5):453-463.
  • Dobiásová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001;34(7):583-588.
  • Grundy SM. Small LDL, atherogenic dyslipidemia, and the metabolic syndrome. Circulation. 1997;95(1):1-4.
  • Nam KW, Kwon HM, Park JH, Kwon H. The atherogenic index of plasma is associated with cerebral small vessel disease: a cross-sectional study. J Lipid Atheroscler. 2022;11(3):262-271.
  • Gentile M, Iannuzzo G, Simeon V, et al. Association between atherogenic index of plasma and carotid intima-media thickness in a cohort of Mediterranean women. Acta Cardiol. 2021;76(9):987-992.
  • Tang R, Hennig M, Thomasson B, et al. Baseline reproducibility of B-mode ultrasonic measurement of carotid artery intima-media thickness: the European Lacidipine Study on Atherosclerosis (ELSA). J Hypertens. 2000;18(2):197-201.
  • Mathiesen EB, Bønaa KH, Joakimsen O. Low levels of high-density lipoprotein cholesterol are associated with echolucent carotid artery plaques: the tromsø study. Stroke. 2001;32(9):1960-1965.
  • Sniderman AD, Thanassoulis G, Glavinovic T, et al. Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol. 2019;4(12):1287-1295.
  • Yang C, Sun Z, Li Y, Ai J, Sun Q, Tian Y. The correlation between serum lipid profile with carotid intima-media thickness and plaque. BMC Cardiovasc Disord. 2014;14(1):181.
  • Tamada M, Makita S, Abiko A, Naganuma Y, Nagai M, Nakamura M. Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio as a useful marker for early-stage carotid atherosclerosis. Metabolism. 2010;59(5):653-657.
  • Ding C, Chen Y, Shi Y, et al. Association between nontraditional lipid profiles and peripheral arterial disease in Chinese adults with hypertension. Lipids Health Dis. 2020;19(1):231.
  • Nimkuntod P, Tongdee P. Plasma low-density lipoprotein cholesterol/high-density lipoprotein cholesterol concentration ratio and early marker of carotid artery atherosclerosis. J Med Assoc Thai. 2015;98(Suppl 4):S58-S63.
  • Ohwaki K, Yano E, Tamura A, Inoue T, Saito I. Hypercholesterolemia is associated with a lower risk of cerebral ischemic small vessel disease detected on brain checkups. Clin Neurol Neurosurg. 2013;115(6):669-672.
  • Ikezaki H, Lim E, Cupples LA, Liu CT, Asztalos BF, Schaefer EJ. Small dense low-density lipoprotein cholesterol is the most atherogenic lipoprotein parameter in the prospective Framingham Offspring Study. J Am Heart Assoc. 2021;10(5):e019140.
  • Shoji T, Hatsuda S, Tsuchikura S, et al. Small dense low-density lipoprotein cholesterol concentration and carotid atherosclerosis. Atherosclerosis. 2009;202(2):582-588.
Year 2024, Volume: 6 Issue: 3, 198 - 202, 28.05.2024
https://doi.org/10.38053/acmj.1448539

Abstract

References

  • Naylor AR, Ricco JB, de Borst GJ, et al. Editor’s choice-management of atherosclerotic carotid and vertebral artery disease: 2017 clinical practice guidelines of the European Society for Vascular Surgery (ESVS). Eur J Vasc Endovasc Surg. 2018;55(1):3-81.
  • van Dam-Nolen DHK, Truijman MTB, van der Kolk AG, et al. Carotid plaque characteristics predict recurrent ischemic stroke and TIA: the PARISK (Plaque At RISK) study. Cardiovasc Imaging. 2022;15(10):1715-1726.
  • Yuan S, Tang B, Zheng J, Larsson SC. Circulating lipoprotein lipids, apolipoproteins and ischemic stroke. Ann Neurol. 2020;88(6):1229-1236.
  • Amarenco P, Labreuche J. Lipid management in the prevention of stroke: review and updated meta-analysis of statins for stroke prevention. Lancet Neurol. 2009;8(5):453-463.
  • Dobiásová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem. 2001;34(7):583-588.
  • Grundy SM. Small LDL, atherogenic dyslipidemia, and the metabolic syndrome. Circulation. 1997;95(1):1-4.
  • Nam KW, Kwon HM, Park JH, Kwon H. The atherogenic index of plasma is associated with cerebral small vessel disease: a cross-sectional study. J Lipid Atheroscler. 2022;11(3):262-271.
  • Gentile M, Iannuzzo G, Simeon V, et al. Association between atherogenic index of plasma and carotid intima-media thickness in a cohort of Mediterranean women. Acta Cardiol. 2021;76(9):987-992.
  • Tang R, Hennig M, Thomasson B, et al. Baseline reproducibility of B-mode ultrasonic measurement of carotid artery intima-media thickness: the European Lacidipine Study on Atherosclerosis (ELSA). J Hypertens. 2000;18(2):197-201.
  • Mathiesen EB, Bønaa KH, Joakimsen O. Low levels of high-density lipoprotein cholesterol are associated with echolucent carotid artery plaques: the tromsø study. Stroke. 2001;32(9):1960-1965.
  • Sniderman AD, Thanassoulis G, Glavinovic T, et al. Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol. 2019;4(12):1287-1295.
  • Yang C, Sun Z, Li Y, Ai J, Sun Q, Tian Y. The correlation between serum lipid profile with carotid intima-media thickness and plaque. BMC Cardiovasc Disord. 2014;14(1):181.
  • Tamada M, Makita S, Abiko A, Naganuma Y, Nagai M, Nakamura M. Low-density lipoprotein cholesterol to high-density lipoprotein cholesterol ratio as a useful marker for early-stage carotid atherosclerosis. Metabolism. 2010;59(5):653-657.
  • Ding C, Chen Y, Shi Y, et al. Association between nontraditional lipid profiles and peripheral arterial disease in Chinese adults with hypertension. Lipids Health Dis. 2020;19(1):231.
  • Nimkuntod P, Tongdee P. Plasma low-density lipoprotein cholesterol/high-density lipoprotein cholesterol concentration ratio and early marker of carotid artery atherosclerosis. J Med Assoc Thai. 2015;98(Suppl 4):S58-S63.
  • Ohwaki K, Yano E, Tamura A, Inoue T, Saito I. Hypercholesterolemia is associated with a lower risk of cerebral ischemic small vessel disease detected on brain checkups. Clin Neurol Neurosurg. 2013;115(6):669-672.
  • Ikezaki H, Lim E, Cupples LA, Liu CT, Asztalos BF, Schaefer EJ. Small dense low-density lipoprotein cholesterol is the most atherogenic lipoprotein parameter in the prospective Framingham Offspring Study. J Am Heart Assoc. 2021;10(5):e019140.
  • Shoji T, Hatsuda S, Tsuchikura S, et al. Small dense low-density lipoprotein cholesterol concentration and carotid atherosclerosis. Atherosclerosis. 2009;202(2):582-588.
There are 18 citations in total.

Details

Primary Language English
Subjects Cardiology
Journal Section Research Articles
Authors

Muzaffer Aslan 0000-0003-0670-137X

Doğaç Okşen 0000-0003-4548-9543

Yunus Emre Yavuz 0000-0002-9901-8141

Çağdaş Kaynak 0000-0002-7629-9796

Publication Date May 28, 2024
Submission Date March 7, 2024
Acceptance Date March 24, 2024
Published in Issue Year 2024 Volume: 6 Issue: 3

Cite

AMA Aslan M, Okşen D, Yavuz YE, Kaynak Ç. Atherogenic plasma index is associated with ischemıc cerebrovascular events due to carotid artery disease. Anatolian Curr Med J / ACMJ / acmj. May 2024;6(3):198-202. doi:10.38053/acmj.1448539

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