The recently introduced Coronary Event Risk Test (CERT) is a validated cardiovascular risk predictor that uses circulating ceramide concentrations to allocate patients into one of four risk categories. We here aimed at investigating the power of CERT to predict cardiovascular mortality in 1087 patients with established cardiovascular disease (CVD) including 360 patients with type 2 diabetes (T2DM). At baseline, the prevalence of T2DM increased through CERT categories (29.1, 31.1, 37.4, and 53.4%, respectively, ptrend<0.001). Prospectively, we recorded 130 cardiovascular deaths during a mean follow-up time of 8.1±3.2 years. Overall, cardiovascular mortality increased with increasing CERT categories (Figure) and was higher in T2DM patients than in those who did not have diabetes (17.7 vs. 9.4%; p<0.001). In Cox regression models, CERT categories predicted cardiovascular mortality in patients with T2DM (unadjusted HR 1.60 [1.28-2.01]; p<0.001; HR adjusted for age, gender, BMI, smoking, LDL cholesterol, HDL cholesterol, hypertension, and statin use 1.65 [1.27-2.15]; p<0.001) and in those without diabetes (unadjusted HR 1.43 [1.10-1.85]; p=0.008 and adjusted HR 1.41 [1.07-1.85]; p=0.015). We conclude that CERT predicts cardiovascular mortality in CVD patients with T2DM as well as in those without diabetes.


A. Leiherer: None. A. Muendlein: None. C.H. Saely: None. R. Laaksonen: None. M. Laaperi: None. A. Vonbank: None. B. Larcher: None. A. Mader: None. I. Baumgartner: None. P. Fraunberger: None. H. Drexel: None.

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