BACKGROUND AND AIMS: The recently identified adipokine omentin-1 is inversely associated with body fatness, metabolic syndrome and cardiovascular disease (CVD) in cross-sectional analyses. However, prospective data on the association between plasma omentin-1 levels and future risk of CVD are lacking. The aim of the study was to investigate the relationship between omentin-1 and incident myocardial infarction (MI) and stroke. METHODS: We conducted a case-cohort study nested within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam cohort comprising a subsample of 2084 participants, including 50 CVD cases and 350 external incident CVD cases (mean follow-up of 8.2 +/- 1.6 years). Prentice modified Cox regression adjusted for established CVD risk factors was used to estimate associations between omentin-1 and risk of MI and stroke, interactions were tested with cross-product terms. RESULTS: After multivariable adjustment, omentin-1 was not significantly associated with risk of MI (HR per doubling omentin-1:1.17; 95%-CI:0.79-1.72; p = 0.43), but with higher risk of stroke (HR per doubling omentin-1:2.22; 95%-CI:1.52-3.22; p