부산대학교 도서관

Introduction: Although abdominal fat distribution (AFD), presented as the ratio of visceral adipose tissue (VAT) to subcutaneous adipose tissue (SAT) area (V/S ratio), is possibly associated with an increased risk of cardiovascular disease (CVD), the relationship between V/S ratio and its long-term outcomes have rarely been studied.Methods: We assessed 942 consecutive patients with suspected coronary artery disease who underwent computed tomography (CT) angiography. The patients also underwent plain abdominal CT to measure VAT and SAT areas. The V/S ratio was calculated to assess the AFD. The patients were classified into four groups based on the median V/S ratio and median age (i.e., 0.625 and 69 years, respectively). We examined the association between the V/S ratio and its long-term outcomes in each age group. The primary outcome was major adverse cardiac events (MACEs), including all-cause death, any coronary revascularization, acute coronary syndrome, and emergent hospitalization due to CVD.Results: Over a median follow-up of 1507 days, the incidence of any cardiovascular event was not associated with the V/S ratio among younger patients; however, among older patients, the incidence of MACEs, all-cause death, and any coronary revascularization was higher in the high V/S ratio group than in the low V/S ratio group. According to the Kaplan-Meier analysis, only older patients had a significantly lower MACE-free survival rate in the high V/S ratio group than in the low V/S ratio group, and no differences were noted among the younger patients in both groups. After adjusting for traditional coronary risk factors, high V/S ratio was independently associated with incidence of MACEs in older patients (Figure).Conclusion: A high V/S ratio was associated with an increased risk of MACEs in older patients only. Therefore, a high V/S ratio may be an important risk factor for CVD, particularly in older patients. However, AFD did not affect CVD prognosis among younger patients.