title: The association of visceral adiposity with cardiovascular events in patients with peripheral artery disease.
abstract: BACKGROUND
  Previous studies have suggested that patients with peripheral artery disease (PAD) suffer from a high incidence of cardiovascular events (CVE). Visceral adiposity has been implicated in promoting CVEs. This study aimed to assess the association of relative visceral adipose volume with incident cardiovascular events in patients with peripheral artery disease.
  
  
  METHODS
  This was a prospective cohort study including 260 patients with PAD who presented between 2003 and 2012. Cases were patients with diagnosed PAD including symptomatic lower limb athero-thrombosis and asymptomatic abdominal aortic aneurysm. All patients underwent computed tomography angiography (CTA). Abdominal visceral to total adipose volume ratio (relative visceral adipose volume) was estimated from CTAs using a previously validated workstation protocol. Cardiovascular risk factors were recorded at entry. The association of visceral adiposity with major CVEs (death, non-fatal myocardial infarction or stroke) was examined using Kaplan Meier and Cox proportional hazard analyses.
  
  
  RESULTS
  A total of 92 major CVEs were recorded in 76 patients during a median follow-up of 2.8 (IQR 1.2 to 4.8) years, including myocardial infarction (n = 26), stroke (n = 10) and death (n = 56). At 3 years the incidence of major CVEs stratified by relative visceral adipose volume quartiles were 15% [Quartile (Q) 1], 17% (Q2), 11% (Q3) and 15% (Q4) (P = 0.517). Relative visceral adipose volume was not associated with major CVEs after adjustment for other risk factors.
  
  
  CONCLUSIONS
  This study suggests that visceral adiposity does not play a central role in the predisposition for major CVEs in patients with PAD.
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
authors.forename: Oliver
authors.initials: O
authors.lastname: Cronin
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bradshaw
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia ; Discipline of Surgery and Centre for Clinical Research, School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Vikram
authors.initials: V
authors.lastname: Iyer
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Cunningham
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia ; School of Public Health, Tropical Medicine and Rehabilitation Sciences, James Cook University, Townsville, Queensland, Australia.
authors.forename: Petra
authors.initials: P
authors.lastname: Buttner
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia ; Discipline of Surgery and Centre for Clinical Research, School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
authors.forename: Philip J
authors.initials: PJ
authors.lastname: Walker
authors.affiliation: Queensland Research Centre for Peripheral Vascular Disease, School of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia ; Discipline of Surgery and Centre for Clinical Research, School of Medicine, University of Queensland, Brisbane, Queensland, Australia; Department of Vascular Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia ; Department of Vascular and Endovascular Surgery, The Townsville Hospital, Townsville, Queensland, Australia.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Golledge
mesh_terms: D050154:Adiposity; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000473:pathology; D008297:Male; D058729:Peripheral Arterial Disease / Q000150:complications / Q000209:etiology / Q000473:pathology*; D014057:Tomography, X-Ray Computed