376-P: REWIND Data on Obesity and Cardiovascular (CV) Health: Waist-to-Hip Ratio (WHR) Independently Predicted CV Outcomes

Abstract

Obesity is a major risk factor (RF) for health outcomes such as major adverse cardiovascular events (MACE) and cardiovascular disease (CVD)-related mortality. WHR is a validated measure of central adiposity and has been shown to predict CVD events. The aim of this post hoc analysis was to evaluate if WHR, adjusted for age and sex, was an independent RF for developing MACE-3 (non-fatal myocardial infarction (MI), non-fatal stroke, or CV death) and CVD-related mortality. Data from the REWIND trial placebo group (N=4952) were analyzed. All participants had type 2 diabetes, were aged 50 or older, and had either a previous CV event or CV RFs. During the median follow-up of 5.4 years, there were 663 patients with MACE-3 and 346 CVD-related deaths. A Cox proportional hazard model was used to investigate if WHR, adjusted for age and sex, was a significant RF for MACE-3 and CVD-related mortality, followed by testing additional baseline RFs (demographic, CVD history, and biochemical characteristics) using a stepwise variable selection method where WHR, age, and sex were forced into the model. BMI was tested similarly to WHR. WHR, but not BMI, was an independent risk factor for MACE-3 and CVD-related mortality. As expected, age and sex were significant RFs for both endpoints and were therefore adjusted in the model. Urinary albumin:creatinine ratio (UACR), non-HDL-C, and race (white) were significant RFs for MACE-3. UACR, LDL-C, history of MI, and race (American Indian/Alaska Native) were significant RFs for CVD-related mortality. In the resulting adjusted model, for every unit increase in WHR, there was an estimated 3.50-fold increase in MACE-3 risk (p=0.013) and 5.51-fold increase in CVD-related mortality risk (p=0.005). WHR was an independent predictor of MACE-3 and CVD-related mortality, indicating that central adiposity should be assessed and addressed in patients with or who have a high risk of CVD. Disclosure E. Franek: Advisory Panel; Self; Boehringer Ingelheim, Novo Nordisk, Speaker’s Bureau; Self; Boehringer Ingelheim. P. Pais: None. J. N. Basile: Other Relationship; Self; Medtronic, Research Support; Self; Eli Lilly and Company, ReCor. S. Raha: Employee; Self; Eli Lilly and Company. N. Ahmad: Employee; Self; Eli Lilly and Company. H. Kan: Employee; Self; Eli Lilly and Company, Stock/Shareholder; Self; Bristol-Myers Squibb Company, GlaxoSmithKline plc. M. Konig: Employee; Self; Eli Lilly and Company.