Comparison of Plasma Postprandial Versus Fasting Atherogenic Index in Predicting Contrast-Induced Nephropathy After Acute Coronary Syndrome

Abstract

Contrast-induced nephropathy (CIN) is a common complication in patients undergoing percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). The atherogenic index of plasma (AIP; log [triglyceride/high-density lipoprotein cholesterol (HDL-C)]), is linked to cardiovascular risk, but the value of postprandial AIP (PAIP) versus fasting AIP (FAIP) for predicting CIN is unclear. The present study compared the predictive ability of PAIP and FAIP for CIN in ACS patients undergoing PCI. ACS patients (n = 882) were analyzed, with 512 in the FAIP group and 370 in the PAIP group, based on the timing of lipid panel collection. CIN occurred in 15.6% of the FAIP group and 16.2% of the PAIP group (P = .813). AIP was significantly higher in the PAIP group (0.643 ± 0.264) compared with the FAIP group (0.493 ± 0.262, P < .001). AIP was an independent predictor of CIN in both groups, with stronger predictive power in the PAIP group (OR 46.57, P < .001) versus the FAIP group (OR 6.33, P = .003) Receiver operating characteristic (ROC) analysis showed a higher area under the curve (AUC) for PAIP (0.712) than FAIP (0.670, P < .001). PAIP is a superior predictor of CIN compared with FAIP, emphasizing the importance of the postprandial lipid profile in ACS patients.