| Summary: | Abstract Background Aberrant lipid metabolism is associated with the development of coronary artery aneurysms (CAA). Research on the association between traditional and nontraditional lipid parameters, as well as CAA, in patients undergoing coronary angiography is limited. Therefore, this study aimed to investigate and compare the effects of lipid parameters on CAA development. Methods 160 patients with CAA and 160 patients without CAA were included in this study. Traditional lipid parameters were calculated and compared between the two groups. Multivariate logistic analysis and restricted cubic spline (RCS) were used to explore the association between lipid indicators and CAA incidence. Receiver operating characteristic (ROC) curves were used to evaluate the predictive value of lipid parameters. Results Serum triglyceride (TG), atherogenic index of plasma (AIP), lipoprotein combine index (LCI), AC, Castelli’s index-I (CRI-I), and CRI-II were all significantly higher in patients with CAA, while high-density lipoprotein cholesterol (HDL-C) and remnant cholesterol (RC) were lower in CAA group compared with control group (p < 0.05). Multivariate logistic regression analysis showed that TG, AIP, LCI, AC, CRI-I, and CRI-II were all independent risk factors for CAA, whereas total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), non-HDL-C, and RC/HDL-C were not associated with CAA after adjusting for covariates. Among these traditional and nontraditional lipid parameters, AIP exhibited the highest area under the curve (AUC) for predicting CAA (AUC = 0.712, 95% confidence interval (CI): 0.633–0.791, p < 0.001), suggesting that nontraditional lipid parameters have outstanding predictive power for CAA. Conclusions Patients with CAA had higher levels of traditional lipid parameters. Among these lipid indicators, the AIP had the highest predictive potential for CAA.
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