Objective: Despite the clinical significance of cardiovascular–kidney–metabolic (CKM) syndrome, evidence regarding the risk of major adverse cardiovascular events (MACE) and all-cause mortality across distinct CKM syndrome stages remains limited. This study evaluated the prevalence of CKM syndrome stages and their relationship with MACE in a representative Korean cohort.Design and method: We conducted a retrospective cohort study using data from the 2009–2010 National Health Screening Program. Participants were classified into CKM syndrome stages. MACE was defined as nonfatal myocardial infarction, nonfatal stroke, or cardiovascular death, with outcomes analysed via Kaplan–Meier curves and Cox proportional hazards regression over an average follow-up of 11.6 years. Results: Among 7,400,326 adults, prevalence of CKM syndrome stages was 22.4% for stage 0, 23.5% for stage 1, 45.1% for stage 2, 6.3% for stage 3, and 2.7% for stage 4. A stepwise increase in risk of MACE was observed with advancing stages; adjusted hazard ratios were 1.16 for stage 1, 1.96 for stage 2, 2.43 for stage 3, and 3.29 for stage 4, compared to stage 0. Adjusted survival curve analysis verified lower event-free survival as CKM syndrome stages advanced. A stepwise increase in all-cause mortality risk was observed with advancing CKM syndrome stages, except for stage 1. Conclusions: Advanced CKM syndrome stages were strongly associated with escalating MACE risk in the Korean population. These findings emphasize the need for early detection and tailored, stage-specific interventions to mitigate cardiovascular morbidity and mortality.
Park et al. (Fri,) studied this question.