Elevated atherogenic index of plasma associated with stroke risk in general Chinese

Background and aims The atherogenic index of plasma (AIP) is supposed to be associated with cardiovascular disease (CVD), but there is limited evidence on its longitudinal effect. Our study aimed to explore the associations between baseline and long-term AIP with the risk of stroke and its subtypes. Methods and results A total of 97,959 participants free of stroke at baseline were included in the Kailuan study. The AIP was calculated as the logarithm of the ratio of triglyceride to high-density lipoprotein cholesterol. The updated mean AIP was calculated as the average of the AIP from baseline to the first occurrence of outcome or the end of follow-up. The outcome was the first occurrence of stroke, including ischemic stroke (IS) and intracerebral hemorrhage (ICH). We used univariable and multivariable Cox proportional hazard models to explore the association between AIP and the risk of stroke. During a median follow-up of 12.79 years, a total of 6307 participants developed stroke, including 5482 IS and 1024 ICH. Compared with the 1st quartile of baseline AIP, the multivariate-adjusted HR in the 4th quartile was 1.12 (95% CI, 1.03–1.22, p for trend <0.001) for stroke risk. Same results were found in IS, but no significant association was found for ICH. The associations between updated mean AIP and stroke and its subtypes showed similar results. Conclusions Elevated levels of both baseline and long-term updated mean AIP were associated with the risk of stroke and IS but not ICH in the general population.