Can the Atherogenic Index of Plasma (AIP) Be a Prognostic Marker for Good Clinical Outcome After Mechanical Thrombectomy for Acute Ischemic Stroke?

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Background: Stroke remains a leading cause of morbidity and mortality worldwide, with dyslipidemia playing a crucial role in atherosclerosis and stroke development. The Atherogenic Index of Plasma (AIP), calculated as log(triglyceride/HDL), has emerged as a biomarker for atherosclerosis and cardiovascular risk. However, its relationship with stroke prognosis remains unclear. This study aimed to investigate the association between AIP and favorable clinical outcomes at three months in acute ischemic stroke patients undergoing mechanical thrombectomy. Methods: We conducted a retrospective analysis of 222 patients who underwent mechanical thrombectomy between December 2019 and April 2023. The association between AIP and demographic variables, etiology, successful recanalization, intracerebral hemorrhage, and three-month mRS was evaluated. AIP values were compared between patients with good (mRS 0–2) and poor (mRS 3–6) clinical outcomes. Results: The most common comorbidity was hypertension (72.1%), followed by AF (50%). Stroke etiologies included large artery atherosclerosis (16.2%), cardioembolism (57.2%), and undetermined causes (26.6%). AIP values were significantly lower in patients with good functional outcomes. Additionally, AIP values were inversely associated with AF but positively correlated with DM and previous stroke history. No significant relationship was observed between the AIP and successful recanalization or intracerebral hemorrhage. Conclusions: This study is the first to demonstrate that elevated AIP is associated with poor functional outcomes after three months in patients undergoing mechanical thrombectomy. Given its strong correlation with prognosis, the AIP may serve as a valuable biomarker for identifying high-risk patients. Future prospective studies are needed to further validate these findings and explore the potential role of the AIP in stroke management.