445-P: Waist–to–Body-Mass-Index Ratio Predicts Cardiovascular Events in Patients with Cardiovascular Disease Independently of Type 2 Diabetes

Waist circumference reflects central fat accumulation and is an important additive information to BMI. The Waist Circumference-to-Body-Mass-Ratio (W/BMI-Ratio) has been suggested to provide additional information on cardiovascular event risk. Its power to predict cardiovascular events in patients with established cardiovascular disease is unclear and is addressed in the present study. We prospectively recorded cardiovascular events in 1200 patients with angiographically verified coronary artery disease (n=938) or sonographically proven peripheral artery disease. The mean follow-up time was 10.4±5.0 years. At baseline, there was no significant difference in the W/BMI-Ratio between patients with (n=422) and those without T2DM (3.6±0.4 vs. 3.6±0.3; p=0.442). Prospectively, the W/BMI-Ratio significantly predicted the incidence of cardiovascular events (n=642) both univariately (standardized HR 1.14 [1.07-1.22], p<0.001) and after adjustment for age, gender, smoking, LDL cholesterol, HDL cholesterol, hypertension and T2DM (standardized adjusted HR=1.15 [1.07-1.23], p<0.001); HRs were 1.12 [1.02±1.22], p=0.014 in patients without diabetes and 1.23 [1.09-1.38], p<0.001 in those with T2DM, with a non-significant interaction W/BMI-Ratio x diabetes status (p=0.159). We conclude that the W/BMI-Ratio independently from diabetes status is a predictor for cardiovascular events in patients with established cardiovascular disease.