Cardiovascular diabetology · 2026
Association between atherosclerotic index of plasma and long-term aortic-related adverse events in type B aortic dissection patients undergoing thoracic endovascular aortic repair.
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Li Shuangshuang, Li Wen, Zhang Jiahe, Zhao Kaiwen, Ding Zhichen, Ren Jianli, Hu Wenping, Lu Qingsheng, Zhou Jian
Аннотация
BACKGROUND: Previous research identifies the atherosclerotic index of plasma (AIP) as a key marker for cardiovascular risk, but its role in predicting outcomes in type B aortic dissection (TBAD) patients after thoracic endovascular aortic repair (TEVAR) is uncertain. This study aimed to investigate the association between AIP and long-term outcomes in TBAD patients after TEVAR.
METHODS: This retrospective cohort study included 1335 patients with TBAD who underwent TEVAR. Patients were stratified into tertiles based on AIP levels. The primary endpoints were aortic-related adverse events (ARAEs) at 1 and 5 years after TEVAR. Cox regression analyses were used to evaluate the independent effect of AIP on outcomes. Kaplan-Meier (KM) analysis was conducted to compare the incidence of ARAEs among different groups. Restricted cubic spline (RCS) models were utilized to investigate the nonlinear relationship between AIP and ARAEs, and subgroup analyses assessed the stability of this association. Time-dependent receiver operating characteristic (ROC) curves were applied to assess the predictive accuracy of AIP for ARAEs over a 5-year period.
RESULTS: The KM analysis revealed a significantly higher incidence of ARAEs in the high AIP group compared to the low AIP group (P < 0.001). However, no statistically significant differences were found in all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCEs) (all P > 0.05). Cox regression analysis demonstrated that a high level of AIP was associated with an increased risk of ARAEs (all P < 0.001). Additionally, RCS analysis indicated a linear relationship between AIP and the risk of ARAEs. In subgroup analyses, the timing of operation showed a significant interaction with 1-year ARAEs (P for interaction = 0.008). Time-dependent ROC analysis demonstrated an area under the curve approaching 0.8 throughout the 5-year period.
CONCLUSION: Our research indicates that AIP is independently associated with 1-year and 5-year ARAEs in patients with TBAD following TEVAR, providing a novel metabolic perspective for the prognostic evaluation of this population.
METHODS: This retrospective cohort study included 1335 patients with TBAD who underwent TEVAR. Patients were stratified into tertiles based on AIP levels. The primary endpoints were aortic-related adverse events (ARAEs) at 1 and 5 years after TEVAR. Cox regression analyses were used to evaluate the independent effect of AIP on outcomes. Kaplan-Meier (KM) analysis was conducted to compare the incidence of ARAEs among different groups. Restricted cubic spline (RCS) models were utilized to investigate the nonlinear relationship between AIP and ARAEs, and subgroup analyses assessed the stability of this association. Time-dependent receiver operating characteristic (ROC) curves were applied to assess the predictive accuracy of AIP for ARAEs over a 5-year period.
RESULTS: The KM analysis revealed a significantly higher incidence of ARAEs in the high AIP group compared to the low AIP group (P < 0.001). However, no statistically significant differences were found in all-cause mortality and major adverse cardiovascular and cerebrovascular events (MACCEs) (all P > 0.05). Cox regression analysis demonstrated that a high level of AIP was associated with an increased risk of ARAEs (all P < 0.001). Additionally, RCS analysis indicated a linear relationship between AIP and the risk of ARAEs. In subgroup analyses, the timing of operation showed a significant interaction with 1-year ARAEs (P for interaction = 0.008). Time-dependent ROC analysis demonstrated an area under the curve approaching 0.8 throughout the 5-year period.
CONCLUSION: Our research indicates that AIP is independently associated with 1-year and 5-year ARAEs in patients with TBAD following TEVAR, providing a novel metabolic perspective for the prognostic evaluation of this population.