Uso de índices aterogênicos como métodos de avaliação das doenças ateroscleróticas clínicas

Abstract

BACKGROUND: The search for clinically useful assessment methods, with good accuracy, low cost, non-invasiveness and easy handling, has been stimulated for years. Thus, the atherogenic indices evaluated in this study may fit this growing demand. OBJECTIVES: To assess the potential of atherogenic indices as methods for evaluating patients with clinical atherosclerosis. METHODS: Single center cross-sectional study, through which the Castelli I and II indices, the atherogenic index of plasma (AIP), the lipoprotein combine index and the variation in the peripheral perfusion index between 90 and 120 seconds after an endotheliumdependent vasodilator stimulus (?PI90-120) were evaluated in the prediction of atherosclerosis. RESULTS: The sample consisted of 298 individuals with a mean age of 63.0 ± 16.1 years, of which 57.4% were women. Paired comparisons of the ROC (receiver operator character) curve analysis of the indices that reached area under the curve (AUC) > 0.6 show that ?PI90-120 and AIP were superior to the other indices, and with no difference between them observed (difference between AUC = 0.056;95%CI -0.003-0.115). Furthermore, both ?PI90-120 [OR (odds ratio) 9.58; CI (95% confidence interval 4.71-19.46) and AIP (OR 5.35; 95% CI 2.30-12.45) were independent predictors of clinical atherosclerosis. CONCLUSIONS: The AIP and ?PI90- 120 showed better accuracy to discriminate individuals with clinical atherosclerosis compared to the other indices evaluated in the sample evaluation. In addition, they were independent predictors for clinical atherosclerosis, with high negative predictive values and negative likelihood ratio considerations, showing a promising possibility in excluding the diagnosis of clinical atherosclerotic diseases, making them suitable for multicentric studies from the cost point of view and practicality.