Current Medicinal Chemistry · Mar 13, 2026

Association Between Atherogenic Index of Plasma and Cardiovascular Events or Mortality in the General Population: A Meta-Analysis of Longitudinal Studies

By Cai J, Zhang Y, Fan Y

INTRODUCTION: The balance between plasma triglycerides and high-density lipoprotein cholesterol is evaluated using the Atherogenic Index of Plasma (AIP). We aimed to synthesize evidence from meta-analyses on the association between the AIP and major adverse cardiovascular events (MACEs) or mortality in the general population. METHODS: Embase, Web of Science, and PubMed were searched for publications up to January 28, 2025. Cohort studies reporting the association between AIP and the risks of MACEs and mortality in the general population were included. RESULTS: Fifteen studies (16 articles), encompassing a total of 901,640 individuals, met the inclusion criteria. Comparing individuals with the highest AIP to those with the lowest, the pooled adjusted HR indicated significantly elevated risks MACEs (hazard ratios [HR] 1.33; 95confidence intervals [CI] 1.22-1.46), coronary heart disease (CHD) (HR 1.72; 95% CI 1.51-1.95), stroke (HR 1.49; 95% CI 1.03-2.15), all-cause mortality (HR 1.24; 95% CI 1.10-1.39), and cardiovascular mortality (HR 1.17; 95% CI 1.05-1.31). However, the observed association between elevated AIP and stroke was not confirmed in the sensitivity analysis. DISCUSSION: These findings suggest that measuring blood AIP level may help identify high-risk individuals for death and cardiovascular events in the general population. However, the results of subgroup analyses should be interpreted cautiously due to the limited number of studies available within each subgroup. CONCLUSION: Elevated AIP is an independent predictor of MACEs, CHD, cardiovascular mortality, and all-cause mortality in the general population. Further prospective studies are essential to validate these findings and to optimize the clinical application of AIP.

doi.org/10.2174/0109298673412215251211122028PubMed 41832710Biomarkers