Visceral Adiposity Index in Coronary Artery Ectasia

Coronary artery ectasia (CAE) describes abnormal widening of the epicardial coronary arteries, generally attributed to dysregulated remodeling of the arterial wall. Combining body composition and lipid parameters, the visceral adiposity index (VAI) provides an indirect reflection of dysfunctional adipose tissue and related metabolic risk. The analysis specifically evaluated differences in VAI between patients with isolated CAE and those with unremarkable coronary angiograms, as well as the independent association between VAI and CAE.

Records of adults who underwent coronary angiography at a single tertiary‑care institution between March 2024 and March 2026 were retrospectively reviewed. Isolated CAE was defined as ectatic dilatation of at least 1 epicardial coronary artery to ≥1.5 times the adjacent reference diameter, without stenosis of ≥50% in any major epicardial vessel. To reduce baseline imbalance, propensity score matching was applied, yielding 57 isolated-CAE patients and 57 patients with normal coronary arteries (NCA). Sexspecific formulas were used to derive each patient's VAI. The relationship of VAI-CAE was modeled using multivariable logistic regression, and its discriminative capacity was characterized through receiver operating characteristic curve analysis.

The final matched sample consisted of 114 patients. Visceral adiposity index was higher among those with CAE than among NCA controls (3.01 ± 1.49 vs. 1.95 ± 1.05;P < .001), and the CAE group likewise showed greater body mass index, waist circumference, and triglycerides alongside lower high-density lipoprotein cholesterol (all P < .05). This VAI-CAE association persisted after multivariable adjustment.

Isolated CAE was linked to a metabolic profile suggestive of unfavorable visceral adiposity. While VAI could add complementary metabolic insight in this patient group, larger prospective studies are needed before firmer conclusions can be drawn. Cite this article as: Aslan V, Sural S. Visceral adiposity index in coronary artery ectasia. Eurasian J Med. 2026, 58(4), 1588, doi: 10.5152/ eurasianjmed.2026.261588.