471-P: The Visceral Adiposity Index Predicts MACE Both in Cardiovascular Disease Patients with and in Those without Diabetes

The Visceral Adiposity Index (VAI) is calculated based on waist circumference, BMI, triglyzeride and HDL-cholesterol levels and is a validated measure of visceral adiposity. In the general population, the VAI has been shown to be an independent risk factor for premature mortality. Its power to predict MACE in patients with established cardiovascular disease (CVD) with or without type 2 diabetes mellitus (T2DM) is not known and is addressed in the present study. We prospectively recorded MACE in 601 of 1499 patients with either angiographically diagnosed CAD (n=1261) or sonographically verified PAD (n=238) over a mean follow-up time of 9.6±5.1 years. At baseline, the VAI was significantly higher in patients with T2DM (n=489) than in those who did not have diabetes (6.7±6.0 vs. 4.7±4.5; p<0.001). Prospectively, the VAI significantly predicted the incidence of MACE both univariately (standardized HR 1.01 [1.00-1.03]; p=0.037) and after adjustment for age, gender, smoking, LDL cholesterol, hypertension and T2DM (standardized adjusted HR 1.01 [1.00-1.03]; p=0.011); also T2DM significantly predicted MACE in this fully adjusted model (adjusted HR 1.55 [1.31-1.84]; p<0.001). We conclude that the VAI and T2DM are mutually independent predictors of MACE in patients with CVD.