Association of Cardiovascular-Kidney-Metabolic syndrome in young adulthood with subsequent major adverse cardiovascular events, all-cause mortality, and midlife Cardiovascular-Kidney -Metabolic stages

Background Little is known regarding whether Cardiovascular-Kidney-Metabolic (CKM) syndrome stages in young adulthood were associated with subsequent major adverse cardiovascular events (MACE), all-cause mortality, and midlife CKM stages. Method and Results We analyzed a prospective cohort of participants aged 28-39 years. All participants were followed for a median of 24.16 years. In the analysis of 192 MACE and 236 all-cause mortality that occurred among 2,998 participants (CKM stage 0, n=987; stage 1, n=1069; stage 2, n=942), we found that young adults with CKM stage 2 had significantly increased risks of MACE (HR 3.03, [95% CI, 2.01-4.58]) and all-cause mortality (HR 1.81, [95% CI, 1.3-2.54]) compared to those with CKM stage 0. The association of young adulthood CKM stage 1 with MACE and all-cause mortality became non-significant after multivariate adjustment. In a subgroup of 1462 participants with CKM stage 0 or 1 who had data on midlife measures over 10 years later, young adults with CKM stage 1 were at 1.69 times the risk of having CKM stage 2 or higher stages in middle age compared with those with CKM stage 0 (RR 1.69, [95% CI, 1.45-1.97]). Conclusion Young adults with CKM stage 2 had significantly increased risks of MACE and all-cause mortality. Although young adults with CKM stage 1 were not associated with MACE and all-cause mortality, they are at an increased risk of having CKM stage 2 or higher stages in middle age.