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Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus

BACKGROUND: Previous studies reported the prognostic value of the atherogenic index of plasma (AIP) in the course of atherosclerosis and other cardiovascular diseases (CVDs). Still, the predictive utility of the AIP is unknown among patients with type 2 diabetes mellitus (T2DM). METHODS: This was a...

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Autores principales: Fu, Liyao, Zhou, Ying, Sun, Jiaxing, Zhu, Zhaowei, Xing, Zhenhua, Zhou, Shenghua, Wang, Yongjun, Tai, Shi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493717/
https://www.ncbi.nlm.nih.gov/pubmed/34610830
http://dx.doi.org/10.1186/s12933-021-01393-5
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author Fu, Liyao
Zhou, Ying
Sun, Jiaxing
Zhu, Zhaowei
Xing, Zhenhua
Zhou, Shenghua
Wang, Yongjun
Tai, Shi
author_facet Fu, Liyao
Zhou, Ying
Sun, Jiaxing
Zhu, Zhaowei
Xing, Zhenhua
Zhou, Shenghua
Wang, Yongjun
Tai, Shi
author_sort Fu, Liyao
collection PubMed
description BACKGROUND: Previous studies reported the prognostic value of the atherogenic index of plasma (AIP) in the course of atherosclerosis and other cardiovascular diseases (CVDs). Still, the predictive utility of the AIP is unknown among patients with type 2 diabetes mellitus (T2DM). METHODS: This was a secondary analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which randomized 10,251 patients with long-lasting T2DM. ROC curve analysis was used to determine an optimal threshold for AIP, and the study population was divided into high and low AIP groups. Univariable and multivariable Cox proportional hazards regression analyses were used to determine the association between AIP and primary (major adverse cardiovascular events [MACEs], including nonfatal myocardial infarction, nonfatal stroke, and/or death from cardiovascular causes) and secondary outcomes (all-cause mortality). Stratified analyses were performed to control for the confounding factors. RESULTS: AIP was an independent risk factor for the prognosis of T2DM (HR = 1.309; 95% CI 1.084–1.581; P = 0.005). The threshold for AIP was determined to be 0.34 in the study population. After adjustments for confounding factors, multivariable analysis showed that AIP was associated with the risk of MACEs (Model 1: HR = 1.333, 95% CI 1.205–1.474, P < 0.001; Model 2: HR = 1.171, 95% CI 1.030–1.333, P = 0.016; Model 3: HR = 1.194, 95% CI 1.049–1.360, P = 0.007), all-cause mortality (Model 1: HR = 1.184, 95% CI 1.077–1.303, P < 0.001), cardiovascular death (Model 1: HR = 1.422, 95% CI 1.201–1.683, P < 0.001; Model 3: HR = 1.264, 95% CI 1.015–1.573, P = 0.036), and nonfatal myocardial infarction (Model 1: HR = 1.447, 95% CI 1.255–1.669, P < 0.001; Model 2: HR = 1.252, 95% CI 1.045–1.499, P = 0.015; Model 3: HR = 1.284, 95% CI 1.071–1.539, P = 0.007). Subgroup stratified analyses showed that AIP might interact with sex, a classical risk factor of cardiovascular events. CONCLUSIONS: This study showed that AIP might be a strong biomarker that could be used to predict the risk of cardiovascular events in patients with T2DM. Trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-021-01393-5.
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spelling pubmed-84937172021-10-06 Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus Fu, Liyao Zhou, Ying Sun, Jiaxing Zhu, Zhaowei Xing, Zhenhua Zhou, Shenghua Wang, Yongjun Tai, Shi Cardiovasc Diabetol Original Investigation BACKGROUND: Previous studies reported the prognostic value of the atherogenic index of plasma (AIP) in the course of atherosclerosis and other cardiovascular diseases (CVDs). Still, the predictive utility of the AIP is unknown among patients with type 2 diabetes mellitus (T2DM). METHODS: This was a secondary analysis of the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, which randomized 10,251 patients with long-lasting T2DM. ROC curve analysis was used to determine an optimal threshold for AIP, and the study population was divided into high and low AIP groups. Univariable and multivariable Cox proportional hazards regression analyses were used to determine the association between AIP and primary (major adverse cardiovascular events [MACEs], including nonfatal myocardial infarction, nonfatal stroke, and/or death from cardiovascular causes) and secondary outcomes (all-cause mortality). Stratified analyses were performed to control for the confounding factors. RESULTS: AIP was an independent risk factor for the prognosis of T2DM (HR = 1.309; 95% CI 1.084–1.581; P = 0.005). The threshold for AIP was determined to be 0.34 in the study population. After adjustments for confounding factors, multivariable analysis showed that AIP was associated with the risk of MACEs (Model 1: HR = 1.333, 95% CI 1.205–1.474, P < 0.001; Model 2: HR = 1.171, 95% CI 1.030–1.333, P = 0.016; Model 3: HR = 1.194, 95% CI 1.049–1.360, P = 0.007), all-cause mortality (Model 1: HR = 1.184, 95% CI 1.077–1.303, P < 0.001), cardiovascular death (Model 1: HR = 1.422, 95% CI 1.201–1.683, P < 0.001; Model 3: HR = 1.264, 95% CI 1.015–1.573, P = 0.036), and nonfatal myocardial infarction (Model 1: HR = 1.447, 95% CI 1.255–1.669, P < 0.001; Model 2: HR = 1.252, 95% CI 1.045–1.499, P = 0.015; Model 3: HR = 1.284, 95% CI 1.071–1.539, P = 0.007). Subgroup stratified analyses showed that AIP might interact with sex, a classical risk factor of cardiovascular events. CONCLUSIONS: This study showed that AIP might be a strong biomarker that could be used to predict the risk of cardiovascular events in patients with T2DM. Trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000620. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12933-021-01393-5. BioMed Central 2021-10-05 /pmc/articles/PMC8493717/ /pubmed/34610830 http://dx.doi.org/10.1186/s12933-021-01393-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Original Investigation
Fu, Liyao
Zhou, Ying
Sun, Jiaxing
Zhu, Zhaowei
Xing, Zhenhua
Zhou, Shenghua
Wang, Yongjun
Tai, Shi
Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
title Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
title_full Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
title_fullStr Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
title_full_unstemmed Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
title_short Atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
title_sort atherogenic index of plasma is associated with major adverse cardiovascular events in patients with type 2 diabetes mellitus
topic Original Investigation
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8493717/
https://www.ncbi.nlm.nih.gov/pubmed/34610830
http://dx.doi.org/10.1186/s12933-021-01393-5
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