Introduction: Ascending Aortic Aneurysm (AAA) is an aortic disease that can progress with serious complications. The roles of hyperlipidemia and inflammation in its etiology are controversial. This study investigates whether indices that indirectly reflect hypertriglyceridemia (such as Atherogenic Index of Plasma (AIP) and Atherogenic Coefficient (AC) and inflammation (such as Pan-Immune-Inflammation Value  (PIV) and Systemic Immune-Inflammation Index (SII)) have predictive value in assessing the risk and progression of ascending aortic aneurysms.

Methods: This prospective study included 146 patients diagnosed with AAA and 88 controls. Ascending aortic diameters were measured by echocardiography and confirmed by aortic CT. Demographic data, clinical history and laboratory results, including the AIP, AC, PIV, and SII were collected. Statistical analyses were performed to evaluate the relationships between these indices and the aortic diameter. ROC curve analysis was performed to assess the diagnostic ability of the studied indices (such as PIV) to predict the presence of AAA.

Results: While there was no significant difference in PIV, AIP, AC, or SII levels when comparing the two subgroups of AAA patients, the overall comparison between the AAA group and the control group revealed that patients with AAA had significantly higher PIV levels (p=0.026). PIV was the only significant parameter with a p value of 0.026 (AUC: 0.587) according to the ROC analysis. Furthermore, no significant correlation was found between the aortic diameter and the studied indices.

Conclusion: The significant association of PIV with AAA suggests that inflammation may play a critical role in AAA progression. This finding could guide future research towards exploring PIV as a potential marker in clinical settings to identify high-risk patients and tailor management strategies accordingly. Especially in resource-limited settings, these useful indicators can improve AAA management before the disease progresses to an advanced stage.