Int J Angiol 2023; 32(02): 081-087
DOI: 10.1055/s-0043-1764223
Original Article

The Relationship of Plasma Aterogenity Index and Mean Platelet Volume with the Risk of Development of 1-Year Total Major Adverse Cardiac Event in Patients with Non-ST Elevation Myocardial Infarction

Agil Allahverdiyev
1   Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey
1   Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey
2   Department of Cardiology, Faculty of Medicine, Ankara University, Istanbul, Turkey
3   Department of Microbiology, Istanbul University, Ankara, Turkey
1   Department of Cardiology, Faculty of Medicine, Ankara University, Ankara, Turkey
› Author Affiliations
Funding This article did not require receiving specific grants from funding agencies in public, commercial, or non-profit sectors.


In our study, we aimed to reveal the role of plasma atherogenicity index and mean platelet volume in predicting the risk of developing a 1-year major adverse cardiac event (MACE) in patients with non-ST elevation myocardial infarction (NSTEMI).

This study, which was planned from the retrospective cross-sectional study model, was performed with 100 patients diagnosed with NSTEMI and scheduled for coronary angiography. The laboratory values of the patients were evaluated, the atherogenicity index of plasma was calculated, and the 1-year MACE status was evaluated.

In total, 79 of the patients were male and 21 were female. The average age is 60.8 years. At the end of the first year, the MACE improvement rate was found to be 29%. The PAI value was below 0.11 in 39% of the patients, between 0.11 and 0.21 in 14%, and above 0.21 in 47%. The 1-year MACE development rate was found to be significantly higher in diabetic patients and patients with hyperlipidemia. Lymphocyte count and triglyceride values of the patients in the high-risk group of atherogenic index of plasma (AIP) were found to be higher than the patients in the low-risk group. The neutrophil/lymphocyte, thrombocyte/lymphocyte ratios and high-density lipoprotein values of the patients in the high-risk group of AIP were found to be lower than those in the low-risk group. The rate of MACE development was found to be significantly higher in patients in the high-risk group of AIP (p = 0.02). No correlation was found between the mean platelet volume and the MACE development status.

While no significant relationship was found between MPV and MACE in NSTEMI patients, AIP, which includes atherogenic parameters, was found to be correlated with MACE.

Authors' Contributions

All authors of this manuscript meet the authorship criteria according to the latest guidelines of the International Committee of Medical Journal Editors (ICMJE), and all authors have seen and approved the submission and publication of the manuscript .

Ethical Considerations and Approval

The Ethics Committee of Ankara University, Turkey, approved the study (no:I6-473-21). The study was conducted in compliance with the good clinical practices protocol and Declaration of Helsinki principles.

Consent for Publication

All patients were informed about the study procedure and written consent to participate.

Publication History

Article published online:
01 March 2023

© 2023. International College of Angiology. This article is published by Thieme.

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  • References

  • 1 Wilkins E, Wilson L, Wickramasinghe K, Bhatnagar P. European Heart Network. European Cardiovascular Disease Statistics. 2017. Brussels: European Heart Network;
  • 2 Kumar A, Cannon CP. , Eds. Acute coronary syndromes: diagnosis and management, part I. In: Mayo Clinic Proceedings. 2009. Elsevier;
  • 3 Hamm CW, Bassand JP, Agewall S. et al; ESC Committee for Practice Guidelines. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J 2011; 32 (23) 2999-3054
  • 4 Falk E, Nakano M, Bentzon JF, Finn AV, Virmani R. Update on acute coronary syndromes: the pathologists' view. Eur Heart J 2013; 34 (10) 719-728
  • 5 Taskesen T, Sekhon H, Wroblewski I. et al. Usefulness of mean platelet volume to predict significant coronary artery disease in patients with non-ST-elevation acute coronary syndromes. Am J Cardiol 2017; 119 (02) 192-196
  • 6 Dobiásová M, Frohlich J. The plasma parameter log (TG/HDL-C) as an atherogenic index: correlation with lipoprotein particle size and esterification rate in apoB-lipoprotein-depleted plasma (FER(HDL)). Clin Biochem 2001; 34 (07) 583-588
  • 7 Niroumand S, Khajedaluee M, Khadem-Rezaiyan M. et al. Atherogenic Index of Plasma (AIP): a marker of cardiovascular disease. Med J Islam Repub Iran 2015; 29: 240
  • 8 Dobiásová M. [AIP—atherogenic index of plasma as a significant predictor of cardiovascular risk: from research to practice]. Vnitr Lek 2006; 52 (01) 64-71
  • 9 Schoene NW. Design criteria: tests used to assess platelet function. Am J Clin Nutr 1997; 65 (5, Suppl): 1665S-1668S
  • 10 Bath P, Algert C, Chapman N, Neal B. PROGRESS Collaborative Group. Association of mean platelet volume with risk of stroke among 3134 individuals with history of cerebrovascular disease. Stroke 2004; 35 (03) 622-626
  • 11 Tonelli M, Sacks F, Arnold M, Moye L, Davis B, Pfeffer M. for the Cholesterol and Recurrent Events (CARE) Trial Investigators. Relation between red blood cell distribution width and cardiovascular event rate in people with coronary disease. Circulation 2008; 117 (02) 163-168
  • 12 Sim DS, Kim JH, Jeong MH. Differences in clinical outcomes between patients with ST-elevation versus non-ST-elevation acute myocardial infarction in Korea. Korean Circ J 2009; 39 (08) 297-303
  • 13 Dehghani MR, Rezaei Y, Taghipour-Sani L. White blood cell count to mean platelet volume ratio as a novel non-invasive marker predicting long-term outcomes in patients with non-ST elevation acute coronary syndrome. Cardiol J 2015; 22 (04) 437-445
  • 14 Soeiro AM, Silva PGMBE, Roque EAC. et al. Prognostic differences between men and women with acute coronary syndrome. Data from a Brazilian registry. Arq Bras Cardiol 2018; 111 (05) 648-653
  • 15 Fesmire FM, Martin EJ, Cao Y, Heath GW. Improving risk stratification in patients with chest pain: the Erlanger HEARTS3 score. Am J Emerg Med 2012; 30 (09) 1829-1837
  • 16 Conroy RM, Pyörälä K, Fitzgerald AP. et al; SCORE project group. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24 (11) 987-1003
  • 17 Antman EM, Cohen M, Bernink PJ. et al. The TIMI risk score for unstable angina/non-ST elevation MI: a method for prognostication and therapeutic decision making. JAMA 2000; 284 (07) 835-842
  • 18 Backus BE, Six AJ, Kelder JC. et al. Chest pain in the emergency room: a multicenter validation of the HEART score. Crit Pathw Cardiol 2010; 9 (03) 164-169
  • 19 Senaran H, Ileri M, Altinbaş A. et al. Thrombopoietin and mean platelet volume in coronary artery disease. Clin Cardiol 2001; 24 (05) 405-408
  • 20 Chu SG, Becker RC, Berger PB. et al. Mean platelet volume as a predictor of cardiovascular risk: a systematic review and meta-analysis. J Thromb Haemost 2010; 8 (01) 148-156
  • 21 Estévez-Loureiro R, Salgado-Fernández J, Marzoa-Rivas R. et al. Mean platelet volume predicts patency of the infarct-related artery before mechanical reperfusion and short-term mortality in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention. Thromb Res 2009; 124 (05) 536-540
  • 22 Shah B, Oberweis B, Tummala L. et al. Mean platelet volume and long-term mortality in patients undergoing percutaneous coronary intervention. Am J Cardiol 2013; 111 (02) 185-189
  • 23 Ruggiero C, Metter EJ, Cherubini A. et al. White blood cell count and mortality in the Baltimore longitudinal study of aging. J Am Coll Cardiol 2007; 49 (18) 1841-1850
  • 24 Sabatine MS, Morrow DA, Cannon CP. et al. Relationship between baseline white blood cell count and degree of coronary artery disease and mortality in patients with acute coronary syndromes: a TACTICS-TIMI 18 (Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy- Thrombolysis in Myocardial Infarction 18 trial) substudy. J Am Coll Cardiol 2002; 40 (10) 1761-1768
  • 25 Onat A, Can G, Kaya H, Hergenç G. “Atherogenic index of plasma” (log10 triglyceride/high-density lipoprotein-cholesterol) predicts high blood pressure, diabetes, and vascular events. J Clin Lipidol 2010; 4 (02) 89-98