Effects of gender on prognosis of patients with known or suspected coronary artery disease undergoing contrast-enhanced dobutamine stress echocardiography

Predictive Value of the Atherogenic Index of Plasma (AIP) for the Risk of Incident Ischemic Heart Disease among Non-Diabetic Koreans

The atherogenic index of plasma (AIP), composed of triglycerides and high-density lipoprotein cholesterol, is a novel critical marker for assessing the risk of atherogenicity and cardiometabolic health. We aimed to prospectively study the association between AIP and incident ischemic heart disease (IHD) risk in a large cohort of non-diabetic Korean adults. Data were assessed from 17,944 participants without diabetes from the Health Risk Assessment Study (HERAS) and Korea Health Insurance Review and Assessment (HIRA) data. The participants were divided into four groups according to AIP quartiles, calculated as log (triglyceride/high-density lipoprotein cholesterol). We prospectively assessed hazard ratios (HRs) with 95% confidence intervals (CIs) for IHD using multivariate Cox proportional-hazard regression models over a 50-month period that followed the baseline survey. During the follow-up period, 332 participants (1.9%) developed IHD. HRs of IHD for AIP quartiles 2-4 were 1.58 (95% CI, 1.03-2.43), 1.82 (95% CI, 1.20-2.78), and 2.11 (95% CI, 1.37-3.24) after adjusting for age, sex, body mass index, smoking status, alcohol intake, physical activity, mean arterial blood pressure, fasting plasma glucose, high-sensitivity C-reactive protein level, and hypertension medication. Higher AIP levels may precede and predict the development of IHD in non-diabetic Korean adults.

Gender-and lesion number-dependent difference in "atherogenic index of plasma" in Chinese people with coronary heart disease

Few studies has investigated the interrelationship between Atherogenic index of plasma (AIP) and coronary heart disease (CHD) especially in Asians. AIP is the logarithmically transformed ratio of triglyceride (TG) to high-density lipoprotein cholesterol (HDL-C), and is thought to be associated with arteriosclerosis, hypertension, diabetes and cardiovascular diseases. Of the 463 patients from Central Hospital of Nanchong in 2011–2014 diagnosed with angiograms, 229 CHD (>50% stenosis in one or more arteries) and the rest 234 were the controls (maximum stenosis < 10% in any artery) according to the world health organization (who) diagnostic criteria. The multiple regression analysis showed that AIP was independently associated with CHD in men (odds ratio (OR) = 4.44, 95%CI 1.62–12.21, P = 0.004) after adjusting for age, body mass index (BMI), fasting blood glucose(FBG), homocysteine (Hcy), and smoking, but not in women (OR = 0.47, 95%CI 0.11–2.08, P = 0.318). Subgroup analysis showed that the significant difference in AIP between the CHD and the controls only exists in patients with multi-vessel lesions but not in those with single-vessel lesion. Further large-scale studies with balanced sex ratio and vessel lesion numbers should verify the present findings.

Silent myocardial ischemia

Although much progress has been made in reducing mortality from ischemic cardiovascular disease, this condition remains the leading cause of death throughout the world. This might in part be due to the fact that over half of patients have a catastrophic event (heart attack or sudden death) as their initial manifestation of coronary disease. Contributing to this statistic is the observation that the majority of myocardial ischemic episodes are silent, indicating an inability or failure to sense ischemic damage or stress on the heart. This review examines the clinical characteristics of silent myocardial ischemia, and explores mechanisms involved in the generation of angina pectoris. Possible mechanisms for the more common manifestation of injurious reductions in coronary flow; namely, silent ischemia, are also explored. A new theory for the mechanism of silent ischemia is proposed. Finally, the prognostic importance of silent ischemia and potential future directions for research are discussed.