Key result
Higher ePWV is linked to ~32% increased all-cause mortality in CKM syndrome.
Why the study?
The prognostic value and mechanisms of estimated pulse wave velocity in Cardiovascular-Kidney-Metabolic syndrome remained unclear.
Does elevated estimated pulse wave velocity predict increased all-cause and cardiovascular mortality in patients with Cardiovascular-Kidney-Metabolic syndrome?
Cohort (n=34,004)
Does elevated estimated pulse wave velocity predict increased all-cause and cardiovascular mortality in patients with Cardiovascular-Kidney-Metabolic syndrome?
Elevated estimated pulse wave velocity is a strong predictor of all-cause and cardiovascular mortality in CKM syndrome, with kidney function decline mediating approximately a quarter of this risk.
Answers are grounded in this paper and cite their sources.
Should not yet change CKM practice; leaves open whether targeting ePWV or its kidney-mediated pathway improves survival.
AIDS: Cardiovascular-Kidney-Metabolic (CKM) syndrome links metabolic, renal, and cardiovascular disorders. The prognostic value and mechanisms of estimated pulse wave velocity (ePWV) in CKM syndrome remain unclear. METHODS: We analyzed 34,004 CKM syndrome patients from NHANES 1999-2018. Cox regression, restricted cubic splines, and mediation analyses examined ePWV-mortality associations and renal function's mediating role. RESULTS: Over 104 months median follow-up, 4,141 all-cause and 1,261 cardiovascular deaths occurred. In fully adjusted model, each unit ePWV increase associated with 32 % higher all-cause mortality (HR: 1.32, 95 % CI: 1.29-1.35) and 34 % higher CVD mortality (HR: 1.34, 95 % CI: 1.28-1.40). The association showed L-shaped patterns in non-advanced CKM cases and linear relationships in advanced stages. Kidney function decline mediated 24 % of all-cause and 26 % of CVD mortality risk. CONCLUSIONS: Elevated ePWV predicts increased mortality in CKM syndrome patients, with kidney function decline as a significant mediating pathway. These findings highlight the importance of arterial stiffness assessment and renal protection in CKM management.
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Liu et al. (2025) conducted a cohort in Cardiovascular-Kidney-Metabolic (CKM) syndrome (n=34,004). Estimated pulse wave velocity (ePWV) was evaluated on All-cause mortality (HR 1.32, 95% CI 1.29-1.35). Each unit increase in estimated pulse wave velocity was associated with a 32% higher risk of all-cause mortality in patients with CKM syndrome.
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