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

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