High Atherogenic Index of Plasma (AIP) as a Predictor of Poor Coronary Collateral Circulation (CCC) in Patients with Chronic Total Occlusion (CTO)

Background: Chronic Total Occlusion (CTO) of the coronary arteries is a condition where the coronary vessels are completely or nearly obstructed for over three months, indicated by angiographic opacity in the distal vessel through collateral circulation. These collaterals form in response to chronic ischemia. The Atherogenic Index of Plasma (AIP) measures the balance between pro-atherogenic and anti-atherogenic lipoproteins in the blood. AIP is a strong predictor of atherosclerosis and cardiovascular risk factors. Methods: This study is an observational analytic study with a retrospective cohort design. The target population in this study is all patients with Chronic Total Occlusion (CTO). Data were collected from patient medical records. All subjects underwent AIP calculation and CCC degree assessment. Data analysis was conducted using SPSS version 26, including bivariate and multivariate analyses. Results: The study sample consisted of 94 subjects. The ROC analysis resulted in an area under the curve (AUC) of 0.660 (95% CI 0.550-0.770; p=0.008), with a sensitivity of 87.5% and a specificity of 42.6%, and an AIP cut-off value of 0.205. A high AIP value of ≥0.205 significantly increased the risk of poor CCC occurrence in CTO patients by 2.97 times (95% CI 1.30-6.78; p=0.002). Multivariate analysis showed that the most influential factor for poor CCC was high AIP with an HR of 3.676 (95% CI 1.306-10.350; p=0.014). Conclusion: A high Atherogenic Index of Plasma (AIP) is a predictor of poor Coronary Collateral Circulation (CCC) in patients with Chronic Total Occlusion (CTO) at our centre.