The predictive value of atherogenic index of plasma and clonal hematopoiesis of indeterminate potential among patients with STEMI—from a prospective cohort study
Authors' conclusion
These findings establish AIP as a critical modifier of CHIP-related cardiovascular risk, potentially through enhanced inflammatory pathways in younger ACS populations. The study highlights the clinical utility of combining lipid-based (AIP) and genetic (CHIP) biomarkers for precision prognostication, though validation in larger cohorts and mechanistic investigations of the AIP-CHIP interplay are warranted to guide targeted therapies.
Study context
- Population
- Acute coronary syndrome (ACS) patients undergoing primary PCI at Fuwai Hospital (2017–2020)
- Participants
- 1,396 patients
- Exposure
- Clonal hematopoiesis of indeterminate potential (CHIP) carriers vs no CHIP, stratified by atherogenic index of plasma (AIP)
- Outcome
- All-cause mortality
Methodological detailssingle-centre, deep targeted sequencing (42 genes), multivariable Cox regression
- Single-centre
- Deep targeted sequencing (42 genes)
- Multivariable Cox regression
Main finding
As reported in the abstract
All-cause mortality in high-AIP patients
Hazard ratio (95% CI)P value
Any CHIPvs No CHIPhigh AIP
2.38(1.18–4.81)
P log-rank = 0.015Common CHIPvs No CHIPhigh AIP
2.74(1.30–5.08)
P log-rank = 0.008TET2AIP ≥ cutoff
5.20(1.75–15.41)
P = 0.003TET2/ASXL1 co-mutationsAIP ≥ cutoff
5.5(2.02–13.15)
P = 0.001Observational data: associations, not effects.
Further findings
CHIP prevalence
- CHIP mutations (VAF ≥ 2%)
- 14.5%
- DNMT3A
- 23.7%
- TET2
- 2.8%
- ASXL1
- 1.9%
Characteristics of high-AIP vs low-AIP patients
- Age, high vs low AIP
- 57.8 vs. 63.2 years
- hs-CRP, high vs low AIP
- 7.2 vs. 5.8 mg/L
- Higher smoking rates with high AIP
Original publication
The predictive value of atherogenic index of plasma and clonal hematopoiesis of indeterminate potential among patients with STEMI—from a prospective cohort study. Cardiovasc Diabetol. Published 13 August 2025. doi:10.
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