Interplay Between Lipid-Derived Atherogenic Indices and Coronary Artery Calcium Score in Cardiovascular Risk Assessment

Objective

To evaluate the association between lipid-derived atherogenic indices (atherogenic index of plasma (AIP), Castelli Risk Index-I (CRI-I), Castelli Risk Index-II (CRI-II), Atherogenic coefficient (AC), non-HDL-C) and coronary artery calcium score (CACS), and to compare the diagnostic ability of these indices for early diagnosis of coronary artery disease. Methodology: This cross-sectional analytical study took place at departments of Cardiology, Pathology, and Cardiovascular Imaging at Punjab Institute of Cardiology, Lahore, from 2-05-2025 to 28-01-2026. 188 individuals presenting with chest pain were recruited through consecutive sampling. Blood samples were drawn for fasting lipid profile and HbA1c. AIP, CRI-I, CRI-II, AC and non-HDL-C were then calculated using standard formulae. CACS was determined using the Agatston scoring method on coronary CT angiography. Statistical analysis included Pearson’s correlation, one-way ANOVA, and ROC curve analysis. The optimal cut-off value was identified using Youden’s index.