Risk of Cardiovascular Mortality Varies With CKM Stage

Evaluation of the prognostic implications of the staging of cardiovascular-kidney-metabolic (CKM) syndrome is key in informing clinical practice. Sophie E. Claudel, MD, and colleagues conducted a study designed to define the mortality risk associated with each stage of CKM syndrome and identify the corresponding restricted mean survival time over a period of 15 years.

The longitudinal study included 50,678 community-dwelling US adults aged 20 years or older. Eligible patients had available baseline data for CKM stage determination and participated in the 1999 to 2018 National Health and Nutrition Examination Survey. The American Heart Association presidential advisory criteria were used to define CKM stages. Confounder-adjusted survival curves using the G-formula were used to calculate 15-year adjusted cumulative incidences of cardiovascular mortality.

The median follow-up was 9.5 years. During the follow-up period, there were 2,565 cardiovascular deaths. Stratified by stages of CKM, the 15-year adjusted cumulative incidences of cardiovascular mortality were: stage 0, 5.5% (95% CI, 1.8-9.3); stage 1, 5.7% (95% CI, 3.2-8.2); stage 2, 7.9% (95% CI, 6.8-9.1); stage 3, 8.7% (95% CI, 6.7-10.8), and stage 4, 15.2% (95% CI, 13.6-16.8).

At 15 years, the absolute risk difference between CKM stage 4 and CKM stage 0 was 9.6% (95% CI, 5.6-13.6), and the survival difference between CKM stage 0 and CKM stage 4 was 8.1 (95% CI, 8.0-8,2) months.

“Our findings reveal a graded risk of cardiovascular mortality associated with higher CKM syndrome stage,” the researchers concluded.

Source: Claudel SE, et al. J Am Soc Nephrol. doi:10.1681/ASN.0000000637