Association Between the Atherogenic Index of Plasma and the Occurrence of Slow Flow/No-Reflow in Patients With Acute Myocardial Infarction Undergoing Emergency Percutaneous Coronary Intervention.

Abstract

Background: Percutaneous coronary intervention (PCI) is the primary reperfusion strategy for acute myocardial infarction (AMI); however, some patients develop slow flow/no-reflow (SF/NR) after the procedure, which adversely affects prognosis. Atherogenic index of plasma (AIP) is a reliable biomarker of cardiovascular risk, yet its predictive value for SF/NR following emergency PCI in AMI patients remains unclear.

Objective: This study aimed to investigate the association between AIP and the occurrence of SF/NR in AMI patients undergoing emergency PCI.

Methods: A retrospective analysis was conducted on 964 patients initially diagnosed with AMI who underwent PCI. The participants were categorized into SF/NR (n = 251) and normal flow (n = 713) groups on the basis of TIMI flow grade. Statistical analyses including LASSO regression, multivariate logistic regression, ROC curve analysis, RCS regression, subgroup analysis, and the development of a nomogram model were performed.

Results: AIP was identified as an independent risk factor for postoperative SF/NR (OR = 3.184, p < 0.05). The AUC for AIP in the prediction of SF/NR was 0.737. Higher AIP quartiles were associated with increased risk, and a nonlinear relationship was observed. The constructed nomogram model demonstrated good predictive performance (AUC = 0.745), satisfactory calibration in internal validation, and favorable clinical utility. Subgroup analysis confirmed the consistent predictive ability of AIP across different strata.

Conclusion: AIP may be associated with the risk of SF/NR after emergency PCI in AMI patients. Combined with white blood cell count and triglyceride levels, AIP could potentially assist in early identification of high-risk individuals, which warrants further validation in prospective studies. Trial Registration: Chinese Clinical Trial Registry: ChiCTR2500108501.