Diagnostic and prognostic value of the Chinese Visceral Adipose Index in patients with coronary heart disease and metabolic syndrome undergoing percutaneous coronary intervention: a single-centre retrospective study.

OBJECTIVE: Chinese Visceral Adipose Index (CVAI) is a newly developed composite index that integrates age, Body Mass Index (BMI), waist circumference (WC), triglycerides (TG) and high-density lipoprotein cholesterol (HDL-C) to effectively estimate visceral adipose tissue (VAT) in Chinese patients with coronary heart disease (CHD). Given the central role of VAT in the pathogenesis of metabolic syndrome (MetS), current evidence on the relevance of CVAI in diagnosing MetS is scarce, and its predictive value for major adverse cardiac events (MACEs) in MetS patients with CHD after percutaneous coronary intervention (PCI) remains unclear. This study aimed to assess the value of CVAI in evaluating MetS patients with co-existing CHD after PCI. METHODS: This was a retrospective study conducted at a single centre, with enrolment from January to December 2024 and 12-month follow-up after PCI. A total of 561 patients who underwent cardiac catheterisation were recruited from the Department of Cardiology at the Affiliated Hospital of Jiangnan University. According to the diagnostic criteria for metabolic syndrome, participants were categorised into MetS (n=249) and non-MetS (n=312) groups for diagnostic evaluation. Clinical and laboratory data were collected, from which the CVAI was calculated using gender-specific formulas. Diagnostic performance for MetS was evaluated via receiver operating characteristic (ROC) curves. For prognostic analysis, 156 patients with both MetS and CHD who underwent PCI were stratified into high and low CVAI groups based on the median CVAI value. The prognostic value for MACEs within 12 months post-PCI was assessed using multivariate Cox regression and Kaplan-Meier (K-M) analysis. RESULTS: Compared with WC, BMI and TG, the CVAI demonstrated the highest diagnostic accuracy for MetS, with an area under the curve (AUC) of 0.812 and cut-off value of 109.389. After adjusting for known confounders, Cox regression analysis revealed that both high CVAI (HR=2.251, 95% CI 1.139 to 4.450, p<0.05) and Gensini score (HR=1.012, 95% CI 1.001 to 1.022, p<0.05) were risk factors for MACEs within 12 months following PCI in patients with MetS and CHD. Furthermore, Kaplan-Meier analysis (two groups by median CVAI: high CVAI, n=78; low CVAI, n=78) showed that patients in the high CVAI group had a significantly higher incidence of MACEs (47.4% vs 32.1%, p<0.05) compared with those in the low CVAI group. CONCLUSION: The CVAI showed good diagnostic performance in identifying MetS, outperforming several conventional indices in estimating visceral adiposity. It also demonstrated prognostic value in predicting MACEs within 12 months among patients with MetS and CHD undergoing PCI. These findings suggest that CVAI shows promise as a potential clinical tool for cardiometabolic risk assessment and secondary prevention in this patient population, though further validation in larger, prospective studies is warranted.