Abstract
BACKGROUND: The atherogenic index of plasma (AIP) has been related to an increased risk of coronary artery disease. However, previous studies evaluating the prognostic role of AIP for acute coronary syndrome (ACS) showed inconsistent results. This meta-analysis was conducted to systematically evaluate the association between AIP and the risk of major cardiovascular adverse events (MACE) of patients with ACS. MATERIALS AND METHODS: Relevant cohort studies were retrieved by searching electronic databases, including PubMed, Web of Science, and Embase. A random-effects model was used to combine the data by incorporating the influence of between-study heterogeneity. RESULTS: Thirteen datasets from nine cohort studies, involving 10,861 patients with ACS were included in the meta-analysis. Of them, 1546 (14.2%) developed MACE during follow-up. Pooled results suggested that a high AIP at admission was associated with an increased risk of MACE during follow-up (risk ratio [RR]: 1.54, 95% confidence interval [CI]: 1.30-1.82, p < 0.001; I(2) = 48%). Subgroup analyses suggested a stronger association between a high AIP and an increased risk of MACE in older patients (mean age ≥60 years, RR: 2.26, 95% CI: 1.78-2.87, p < 0.001; I(2) = 0%) than the younger ones (mean age <60 years, RR: 1.30, 95% CI: 1.17-1.44, p < 0.001; I(2) = 0%; p for subgroup difference <0.001), which fully explained the heterogeneity. CONCLUSION: A high AIP is associated with an increased risk of MACE in patients with ACS, particularly for older patients.