Is the atherogenic index of plasma a predictor for mortality in ischemic stroke patients?: a retrospective cross-sectional study.

Background: The atherogenic index of plasma (AIP), derived from the logarithmic transformation of the triglyceride to high-density lipoprotein cholesterol ratio, is frequently used to predict cardiovascular events.

Objective: This study aimed to investigate the association between AIP and 1-month mortality in patients with acute ischemic stroke (AIS).

Design and setting: Retrospective study was conducted in Türkiye.

Methods: In total, 530 AIS patients were enrolled in this study. Clinical, demographic, and laboratory characteristics were recorded within 24 hours of admission. One-month mortality outcomes were analyzed in relation to the AIP of the patients.

Results: Of the 530 patients, 140 patients did not survive during the follow-up period. The mean AIP was 0.50 ± 0.33 in survivors and 0.11 ± 0.27 in the mortality group (P = 0.001). In the receiver operating characteristic analysis, the AIP value of 0.291 had a sensitivity of 74.4%, specificity of 76.4%, positive predictive value of 75.92%, and negative predictive value of 74.9% for mortality. The AIP value above 0.291 had an AUC (area under curve) of 0.829 (95% CI [confidence interval] 0.78-0.88, P = 0.0001). In Cox regression analysis, AIP values below 0.291 (HR 3.962; 95% CI 2.643-5.937) were identified as an independent predictor of mortality. Higher mortality rates were observed in patients with cryptogenic stroke and AIP below 0.291 after stratification by stroke TOAST (P = 0.003).

Conclusions: Lower AIP is an independent predictor of short-term mortality in AIS patients, surpassing the sensitivity of traditional lipid parameters. This study provides a valuable prognostic tool for clinicians, offering a non-invasive and cost-effective test for a condition associated with substantial mortality and morbidity.