High cardiovascular-kidney-metabolic risk in atrial fibrillation patients was associated with increased risk of all-cause mortality and MACE compared to low risk (aHR 1.93; 95% CI 1.58-2.36).
Cohort (n=5,577)
Yes
Does high cardiovascular-kidney-metabolic (CKM) risk increase the risk of mortality and major adverse cardiovascular events in patients with atrial fibrillation?
In patients with atrial fibrillation, high cardiovascular-kidney-metabolic (CKM) risk is strongly associated with increased all-cause mortality and MACE, highlighting the need for integrated holistic care.
Hazard Ratio: 1.93 (95% CI 1.58–2.36)
Abstract Background Patients with atrial fibrillation (AF) commonly present with other comorbidities, including metabolic, kidney, or cardiovascular risk factors, which have a complex interplay leading to increased mortality and morbidity. Methods AF patients with available data for CKM staging were included from the EORP-AF and APHRS registries. Patients were stratified into three CKM risk categories based on CKM stage: (i) low CKM risk (CKM stage 2), (ii) moderate CKM risk (CKM stage 3), (iii) high CKM risk (CKM stage 4). Univariate and multivariable Cox regression analysis were performed to assess the associations between CKM risk status and the adverse outcomes including composite outcome (all-cause mortality and major adverse cardiovascular events (MACE)), all-cause mortality, MACE, thromboembolic events, and any major bleeding. Results Total of 5577 patients (age 71.5, SD 10.3; 59.0% male) were enrolled: of these, low, moderate, and high CKM risk groups were present in 1090 (19.5%), 159 (2.9%), and 4328 (77.6%) patients, respectively. Compared to the low CKM risk group, patients in high risk group had significantly higher risk of composite outcome (aHR 1.93; 95% CI 1.58-2.36), all-cause death (aHR 1.90; 95% CI 1.48-2.45), and MACE (aHR 2.28; 95% CI 1.73-3.00). Compared to the patients with moderate CKM risk, the high risk CKM patients experienced higher hazards of MACE (aHR 3.49 95% CI 1.44-8.42) Conclusion High CKM risk was associated with an increased risk of all-cause death and MACE. A holistic or integrated care approach management strategy is recommended to improve clinical outcomes in these patients.Table 1Table 2
Askarinejad et al. (Mon,) conducted a cohort in Atrial fibrillation (n=5,577). High cardiovascular-kidney-metabolic (CKM) risk vs. Low CKM risk was evaluated on Composite outcome of all-cause mortality and major adverse cardiovascular events (MACE) (aHR 1.93, 95% CI 1.58-2.36). High cardiovascular-kidney-metabolic risk in atrial fibrillation patients was associated with increased risk of all-cause mortality and MACE compared to low risk (aHR 1.93; 95% CI 1.58-2.36).