Heart failure & cardiomyopathiesCohort study
Cardiovascular–Kidney–Metabolic Syndrome Stages, Echocardiographic Characteristics, and Heart Failure Risk: The Atherosclerosis Risk in Communities Study
- Prospective cohort study
- community-based
Authors' conclusion
Poor CKM health was widespread among community-dwelling older adults, with higher CKM stage associated with adverse myocardial remodeling and increased risk of incident HF.
Study context
- Population
- Older adults (66 to 90 years) from the ARIC Study, visit 5 (2011–2013), who underwent echocardiography4,827 without prevalent heart failure (HF)
- Participants
- 5,646 adults
- Exposure
- Cardiovascular-kidney-metabolic (CKM) syndrome stages
- Stage 2n = 460reference
- Stage 3n = 3,197
- Outcome
- Incident HF
- Follow-up
- Median 9.0 years
Main finding
As reported in the abstract
Incident HF (656 events)
Stage 0/1
0
events per 1000 person-years
Stage 2
2.9
events/1000 person-years
Stage 3
15.1
events/1000 person-years
Stage 4
37.4
events/1000 person-years
Each group vs stage 2Adjusted hazard ratio (95% CI)P value
Stage 3
3.6(2.1–6.0)
Stage 4
8.3(4.9–14.2)
P < 0.001for trendObservational data: associations, not effects.
Further findings
| Outcome | Stage 0/1 | Stage 2 | Stage 3 | Stage 4 |
|---|---|---|---|---|
| CKM stage distribution · visit 5 | Not reported in the abstract | 8.1% | 56.0% | Not reported in the abstract |
- CKM stage distribution: Stage 0 0.4%
- CKM stage distribution: Stage 1 1.8%
- CKM stage distribution: Stage 4a 32.3%
- CKM stage distribution: Stage 4b 0.3%
Cardiac remodeling and function · visit 7 (2018-2019)
- Higher CKM stage incrementally associated with adverse LV remodeling, worse LV systolic and diastolic function, and greater progression of adverse remodeling
Original publication
Cardiovascular–Kidney–Metabolic Syndrome Stages, Echocardiographic Characteristics, and Heart Failure Risk: The Atherosclerosis Risk in Communities Study. Circulation. Published 1 April 2026. doi:10.1161/circulationaha.125.077894
Summarised from the published abstract; every number is checked against it