The visceral adiposity index (VAI) is a validated tool for the evaluation of visceral adiposity, using waist circumference, serum triglycerides, age and gender to diagnose this metabolic abnormality. It has recently been associated with cardiovascular risk in primary care patients. No data are available on the association of the VAI with mortality in patients with cardiovascular disease (CVD).

We therefore prospectively recorded the incidence of cardiovascular events over a mean follow-up period of 7.9± 3.1 years in a large cohort of 1858 consecutive patients with established cardiovascular disease (1599 patients with angiographically proven coronary artery disease and 259 patients with sonographically proven peripheral artery disease). The VAI was calculated according to the Amato formula; type 2 diabetes (T2DM) was defined according to the ADA definition.

At baseline, the VAI was significantly higher in CVD patients with T2DM than in those who did not have diabetes (347±331 vs. 228±200; p<0.001). Prospectively, 585 vascular events occurred; the event rate was significantly higher in patients with T2DM than in those who did not have diabetes (46.8% vs. 31.3%; p<0.001). After multivariate adjustment, the VAI significantly predicted cardiovascular events in CVD patients with T2DM (standardized adjusted hazard ratio (HR) 1.24 [1.09-1.42]; p=0.007) as well as in

those who did not have T2DM (HR 1.18 [1.06-1.31]; p=0.014).

We conclude that the VAI predicts cardiovascular events both in CVD patients with and in those without diabetes.


C.H. Saely: None. A. Vonbank: None. C. Heinzle: None. D. Zanolin: None. B. Larcher: None. A. Mader: None. A. Leiherer: None. A. Muendlein: None. H. Drexel: None.

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