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Publications

Journal Article Ahead of print

PubMed: 41963235 DOI: 10.1016/j.jcct.2026.03.011

Association between atherogenic index of plasma and rapid progression of coronary atherosclerosis in non-diabetic and diabetic adults: Insight from the PARADIGM study.

J Cardiovasc Comput Tomogr

Authors: Ki-Bum Won, Byoung Kwon Lee, Martin Hadamitzky, Yong-Jin Kim, Ji Min Sung, Edoardo Conte, Gianluca Pontone, Daniele Andreini, Matthew J Budoff, Ilan Gottlieb, Eun Ju Chun, Filippo Cademartiri, Erica Maffei, Hugo Marques, Pedro de Araújo Gonçalves, Jonathon A Leipsic, Sang-Eun Lee, Sanghoon Shin, Jung Hyun Choi, Habib Samady, Kavitha Chinnaiyan, Jagat Narula, Leslee J Shaw, Jeroen J Bax, James K Min, Hyuk-Jae Chang

Affiliations

  • Department of Cardiology, Chung-Ang University Gwangmyeong Hospital, Chung-Ang University College of Medicine, Gwangmyeong, South Korea; CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea.
  • Department of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
  • Department of Cardiovascular Radiology and Nuclear Medicine, TUM University Hospital, German Heart Center, Munich, Germany.
  • Department of Cardiology, Seoul National University College of Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea.
  • CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.
  • IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy; Centro Cardiologico Monzino IRCCS, Milan, Italy.
  • Centro Cardiologico Monzino IRCCS, Milan, Italy; Department of Biomedical, Dental and Surgical Sciences, University of Milan, Milan, Italy.
  • IRCCS Ospedale Galeazzi Sant'Ambrogio, Milan, Italy; Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy.
  • Department of Medicine, Lundquist Institute at Harbor-UCLA, Torrance, CA, USA.
  • Department of Radiology, Casa de Saude Sao Jose, Rio de Janeiro, Brazil.
  • Seoul National University Bundang Hospital, Seongnam, South Korea.
  • Department of Radiology, Fondazione Monasterio, Pisa, Italy; IRCCS SYNLAB SDN, Naples, Italy.
  • IRCCS SYNLAB SDN, Naples, Italy.
  • UNICA, Unit of Cardiovascular Imaging, Hospital da Luz, Lisbon, Portugal.
  • Department of Medicine and Radiology, University of British Columbia, Vancouver, BC, Canada.
  • CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Cardiology, College of Medicine, Ewha Womans University, Seoul, South Korea.
  • Department of Cardiology, College of Medicine, Ewha Womans University, Seoul, South Korea.
  • Department of Cardiology, Pusan University Hospital, Busan, South Korea.
  • Georgia Heart Institute, Northeast Georgia Health System, Gainesville, GA, USA.
  • Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA.
  • University of Texas Health Houston, Houston, TX, USA.
  • Icahn School of Medicine at Mount Sinai, New York, NY, USA.
  • Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands.
  • Cleerly, Inc, New York, NY, USA.
  • CONNECT-AI Research Center, Yonsei University College of Medicine, Seoul, South Korea; Department of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea.

Abstract

BACKGROUND

Despite a significant association of atherogenic index of plasma (AIP) with plasma atherogenicity as well as insulin resistance and new onset of diabetes, data on the risk of rapid plaque progression (RPP) of major epicardial coronary arteries related to AIP according to established diabetes is limited.

METHODS

This study evaluated the association between AIP and RPP according to diabetes in 1485 adults (60.9 ​± ​9.2 years, 58.9% men, 23.8% diabetes) using serial coronary computed tomography angiography. AIP was defined as the base 10 logarithm of the ratio of triglycerides to high-density lipoprotein cholesterol (mmol/L). RPP was defined as a change in percent atheroma volume (PAV) ≥1.0%/year.

RESULTS

During a median follow-up of 3.4 years, the incidence of RPP was 26.1%. Compared with non-diabetic subjects, diabetic subjects exhibited significantly higher AIP levels, larger baseline plaque burden, and higher RPP incidence. After adjusting for age, sex, hypertension, overweight or obesity, current smoking, low-density lipoprotein cholesterol and creatinine levels, baseline total PAV, and the use of aspirin, beta-blockers, angiotensin-converting enzyme inhibitors or angiotensin receptor blockers, or statins, AIP (per 0.1-unit increase) was associated with the risk of RPP in non-diabetic subjects (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01-1.13; p ​< ​0.05) but not in diabetic subjects (OR 1.04, 95% CI 0.95-1.14; p ​= ​0.430).

CONCLUSION

AIP is independently associated with the risk of RPP in the absence of established diabetes. This finding suggests that AIP may be an effective biomarker for predicting RPP in the population of non-diabetic adults.

TRIAL REGISTRATION

ClinicalTrials.govNCT02803411.

MeSH

Diabetes Mellitus, Incidence, Lipoproteins, Radiography, Angiotensins, Cholesterol, Atherosclerosis, Plasma