Elevated atherogenic index of plasma associated with post-stroke epilepsy risk in ischemic stroke patients
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Key Takeaway
Consider AIP as a potential risk marker for post-stroke epilepsy, but recognize this is observational evidence.
A retrospective observational cohort study analyzed 20,538 middle-aged and elderly patients with acute ischemic stroke to investigate the association between atherogenic index of plasma (AIP) and post-stroke epilepsy (PSE) within one year. AIP was calculated as log10 (TG/HDL) from routine lipid profiles, with patients stratified by AIP levels. The primary outcome was PSE development within one year after stroke.
The study found that elevated AIP was significantly associated with higher odds of PSE, though specific effect sizes, absolute numbers, and confidence intervals were not reported. Researchers identified a non-linear threshold effect with an overall inflection point at 0.048 (0.049 for males, 0.026 for females), with the association between AIP and PSE appearing stronger below this threshold. Mediation analysis suggested reciprocal mediation between fibrinogen and AIP on PSE risk, and significant multiplicative and additive interactions were observed between AIP and sex, NIHSS scores, HbA1c, and CRP.
Safety and tolerability data were not reported in the abstract. The retrospective observational design represents a key limitation, as it cannot establish causality between AIP and PSE risk. The absence of reported effect sizes, absolute numbers, and confidence intervals limits interpretation of the association's strength. As a simple metric derived from routine lipid profiles, AIP may have potential utility for risk stratification, but these findings require prospective validation before clinical application.
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View Original Abstract ↓
IntroductionAcute ischemic stroke (AIS) is a major cause of death and disability globally. Post-stroke epilepsy (PSE) adversely affects prognosis and quality of life. This retrospective observational study was to explore the association between the atherogenic index of plasma (AIP) and PSE within one year after AIS.MethodsThis study was a retrospective observational cohort analysis of 20,538 middle-aged and elderly patients with AIS. AIP was calculated as log10 (TG/HDL). Participants were stratified by AIP levels. Multivariable logistic regression, restricted cubic spline analysis, mediation, stratified and interaction analysis were performed.ResultsElevated AIP was significantly associated with higher odds of PSE. A non-linear threshold effect was identified, with an overall inflection point at 0.048 (males: 0.049; females: 0.026), and the association between AIP and PSE was stronger below this threshold. Mediation analysis indicated a reciprocal mediation between fibrinogen and AIP on PSE. Significant multiplicative and additive interactions of AIP with sex, National Institutes of Health Stroke Scale (NIHSS) and hemoglobin A1c (HbA1c) were observed. Significant additive interactions of AIP with C-reactive protein (CRP) were observed.ConclusionElevated AIP was associated with higher risk of PSE within one year after AIS. This association exhibited sex-specific threshold effects, a bidirectional mediating relationship with fibrinogen, and interactive effects with sex, HbA1c, CRP, and NIHSS. As a simple metric derived from routine lipid profiles, AIP may be useful for risk stratification.
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