Objective To explore the association between the atherogenic index of plasma (AIP) and clinical manifestations in patients with coronary artery disease.

Methods A total of 5, 281 patients with coronary artery disease were enrolled as study subjects. General information of the patients, blood lipid indicators and relevant clinical indicators (systolic blood pressure, diastolic blood pressure, heart rate, body mass index and fasting blood glucose level) after admission were collected. AIP was calculated based on triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C). According to AIP quartiles, patients were divided into Q₁ group (n=1, 327, AIP<-0.09), Q₂ group (n=1, 303, AIP≥-0.09 to < 0.29), Q₃ group (n=1, 319, AIP≥0.29 to < 0.71) and Q₄ group (n=1, 332, AIP ≥ 0.71). Multivariate Logistic regression analysis was used to analyze the relationship between AIP levels and the clinical manifestations of patients with coronary heart disease, the New York College of Cardiology (NYHA) cardiac function classification and the Killip classification of patients with myocardial infarction.

Results There were statistically significant differences in age, gender, body mass index, diastolic blood pressure, systolic blood pressure, fasting blood glucose, smoking history, previous history of hypertension, history of diabetes and previous history of atrial fibrillation among the four groups of patients (P < 0.05). After adjusting for covariates such as age, gender and body mass index, multivariate logistic regression analysis found that the AIP level was significantly associated with the risk of presenting clinical manifestations of myocardial infarction in patients with coronary heart disease (P=0.042). The AIP levels of patients who smoked, had systolic blood pressure < 140 mmHg, a history of diabetes, a history of previous percutaneous coronary intervention (PCI) surgery, or no history of previous stroke were significantly associated with the risk of presenting clinical manifestations of myocardial infarction in patients with coronary heart disease (P < 0.05).

Conclusion The AIP level is closely related to the risk of myocardial infarction in patients with coronary heart disease, suggesting that it may have certain application value in the classification of clinical manifestations.