Cardiovascular death risk increases with cardiovascular-kidney-metabolic syndrome stage
Key takeaways:
- Risk for cardiovascular death increased with disease stage, but risk was similar for stages 0 and 1.
- Survival time was reduced by about 5 months for stage 4 vs. stage 0.
Higher stages of cardiovascular-kidney-metabolic syndrome may correlate to increased risk of cardiovascular mortality, according to a longitudinal study of U.S. adults.
“The study underscores a graded risk of cardiovascular mortality associated with increasing stages of cardiovascular-kidney-metabolic (CKM) syndrome in a nationally representative U.S. population,” researchers Sophie E. Claudel, MD, a nephrology fellow, and Ashish Verma, MD, FASN, assistant professor of medicine at Boston Medical Center, told Healio. “The key findings suggest that as CKM stage progresses from stage 0 (no risk factors) to stage 4 (clinical cardiovascular disease), cardiovascular mortality risk significantly increases. Notably, the risk is similar between stage 0 and stage 1, which suggests that stage 1 presents a critical window for early intervention and prevention.”
Researchers analyzed data from the National Health and Nutrition Examination Survey, collected between 1999 and 2018, on 50,678 U.S. adults aged 20 years or older with CKM. The investigation aimed to determine the cumulative incidence of mortality associated with each syndrome stage as well as the corresponding survival time during 15 years. CKM stages were defined by the American Heart Association presidential advisory on CKM syndrome.
Data showed 2,564 patients experienced cardiovascular-related death during 9.5 years. The 15-year adjusted cumulative incidences of cardiovascular mortality showed mortality rate increased as disease stage increased, according to the researchers: Patients with stage 0 had a mortality rate of 5.5% (95% CI, 1.8-9.3); stage 1 had a mortality rate of 5.7% (95% CI, 3.2-8.2); stage 2 had a rate of 7.9% (95% CI, 6.8-9.1); stage 3 had a rate of 8.7% (95% CI 6.7-10.8); and stage 4 reached 15.2% (95% CI, 13.6-16.8).
In addition, there was a 9.6% absolute risk difference between CKM stage 4 and stage 0 (95% CI, 5.6-13.6), and patients in stage 4 had a reduced survival time of approximately 5 months (95% CI, 5.5-5.7 months) vs. stage 0.
“Since stage 1 does not show a significantly elevated risk compared to stage 0, this represents an opportunity for early intervention to prevent progression to higher-risk stages,” Verma and Claudel said. “Given the specificity of CKM staging to cardiovascular mortality, clinicians might consider adopting CKM staging in risk-stratification tools to better guide treatment. The findings highlight the need to increase the use of cardioprotective medications in higher CKM stages, as their usage remains suboptimal.”
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