Association of atherogenic indices with myocardial damage and mortality in COVID-19

PLoS One. 2024 May 16;19(5):e0302984. doi: 10.1371/journal.pone.0302984. eCollection 2024.

Abstract

Background: Lipoproteins in cell membranes are related to membrane stability and play a role against microorganisms. Patients with COVID-19 often experience myocyte membrane damage.

Objective: This study aimed to search the relationship of atherogenic indices with myocardial damage and mortality in COVID-19.

Methods: This was an observational, single-center, retrospective study. The study population was grouped according to in-hospital mortality. C-reactive protein (CRP), CRP to albumin ratio (CAR), monocyte to high density lipoprotein cholesterol ratio (MHR), levels of total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol (HDLc), and low-density lipoprotein cholesterol (LDLc) and cardiac troponin I (cTnI) were recorded. Atherogenic indices (plasma atherogenic index [AIP], atherogenic coefficient [AC], Castelli's risk indices I and II [CRI I and II], triglyceride to HDLc ratio (THR) were calculated.

Results: A total of 783 patients were included. The mortality rate was 15.45% (n = 121). The median age of non-survivor group (NSG) was higher than survivor group (SG) [66.0 years (Q1 -Q3: 55.0-77.5) vs 54.0 years (Q1 -Q3: 43.0-63.0)] (p < 0.001). Study parameters which were measured significantly higher in the NSG were CRP, cTnI, triglyceride, CRI-I, CRI-II, AC, AIP, ferritin, CAR, MHR and THR. LDLc, HDLc, TC and albumin were significantly lower in NSG (p<0.001).

Conclusion: THR is positively correlated with myocardial damage and strongly predicts in-hospital mortality in COVID-19.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Atherosclerosis* / blood
  • Atherosclerosis* / mortality
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • COVID-19* / blood
  • COVID-19* / mortality
  • COVID-19* / pathology
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Female
  • Hospital Mortality*
  • Humans
  • Male
  • Middle Aged
  • Myocardium / metabolism
  • Myocardium / pathology
  • Retrospective Studies
  • SARS-CoV-2 / isolation & purification
  • Triglycerides / blood
  • Troponin I / blood

Grants and funding

The author(s) received no specific funding for this work.