Frequency and Clinical Correlates of Elevated Atherogenic Index of Plasma in Patients with Acute Myocardial Infarction: A Cross-Sectional Study from a Tertiary Care Center

Abstract

Objectives: The Atherogenic Index of Plasma (AIP), defined as the logarithmic ratio of triglycerides to high-density lipoprotein cholesterol, is an emerging lipid-derived marker that reflects the balance between atherogenic and protective lipoproteins. Aim of this study was to determine the frequency of elevated Atherogenic Index of Plasma and examine its association with demographic and clinical characteristics among patients presenting with acute myocardial infarction (AMI). Methodology: This cross-sectional study included 103 patients diagnosed with AMI at a tertiary care hospital. AIP was calculated using fasting lipid parameters, with triglyceride and HDL-C values converted to mmol/L prior to applying the logarithmic formula. AIP values were categorized into low (<0.10), intermediate (0.10–0.24), and high risk (>0.24) groups. Demographic and clinical variables were recorded, and exploratory multivariable logistic regression analysis was performed to identify independent predictors of elevated AIP. Results: High-risk AIP (>0.24) was observed in 55.4% of patients, while 13.6% and 32.0% were classified as intermediate and low risk, respectively. Age above 50 years was significantly associated with elevated AIP (p = 0.018) and remained the only independent predictor in multivariable analysis (adjusted OR 2.83, 95% CI 1.25–6.63, p = 0.014). Lipid parameters showed strong correlations with AIP, with triglycerides positively (ρ = 0.887, p < 0.001) and HDL-C negatively (ρ = −0.622, p < 0.001) associated. Other clinical variables, including gender, diabetes, hypertension, smoking, anemia, and physical activity, were not significantly associated after adjustment. Conclusion: Elevated AIP is highly prevalent among patients presenting with AMI and is primarily driven by underlying lipid abnormalities. While age appears to be an independent predictor, the cross-sectional design limits causal inference. Further large-scale prospective studies are required to evaluate the prognostic significance of AIP in cardiovascular risk stratification.