Improving cardiovascular risk stratification: the role of abdominal obesity in predicting Major Adverse Cardiovascular Events (MACEs)
Authors' conclusion
Abdominal obesity and low HDL-c are potent, independent predictors of cardiovascular events, outperforming traditional markers like BMI. Together with the need of reaching LDL-c serum target levels, these biomarkers are crucial for unmasking the residual risk missed by current stratification models.
Study context
- Population
- Outpatients of an Italian Internal Medicine Unit, initially free of MACE (347 males, 389 females)
- Participants
- 736 outpatients
- Exposure
- Abdominal obesity vs no abdominal obesity
- Outcome
- Incident MACE
- Follow-up
- Median 84.9 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Abdominal obesity vs No abdominal obesityOdds ratio (95% CI)P value
Incident MACE
1.784(1.04–3.118)
P = 0.038Multivariate logistic regression adjusted for age and other MetS components
2.2(1.6–4.2)
P = 0.001- MACE in the cohort
- 132 participants (17.9%)
- Abdominal obesity prevalence at baseline
- 78.1%
- BMI-defined obesity not associated with MACE
- P = 0.394
Observational data: associations, not effects.
Further findings
Low HDL-C and MACE
- Low HDL-C, OR
- 1.672 (1.115-2.482), p = 0.012 (95% CI)
- Low HDL-C, multivariate adjusted OR
- 1.9 (1.4-3.5), p = 0.001 (95% CI)
SCORE2/SCORE2-OP 'Moderate-Risk' category
- Highest baseline LDL-C levels; largest proportion of MACE
- 36.4%
Participants without baseline abdominal obesity: those developing MACE vs not
- Significantly higher waist circumference (WC)
- P < 0.0001
- Lower HDL-C
- P = 0.0078
Original publication
Improving cardiovascular risk stratification: the role of abdominal obesity in predicting MACEs. Cardiovasc Diabetol. Published 11 August 2025. doi:10.
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