Observational studyCardiovascular diabetology2025
Cardio-kidney-metabolic complexity in patients with atrial fibrillation: an analysis from the prospective GLORIA-AF registry phase III.
Observational study in Cardiovascular diabetology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Major bleeding modifiers in anticoagulated patients with atrial fibrillation and heart failure: a systematic review.Journal of thrombosis and thrombolysis · 2026Review
- Cardio-Kidney-Metabolic Phenotypes in Atrial Fibrillation.JACC. Asia · 2026Article
- Cardio-Kidney-Metabolic Phenotypes and Adverse Clinical Outcomes in Patients With Atrial Fibrillation.JACC. Asia · 2026Article
- Cardiovascular-kidney-metabolic interplay in patients with atrial fibrillation receiving direct oral anticoagulants.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2026Article
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCardio-Kidney-Metabolic (CKM) syndrome results from the complex interaction of cardiovascular, renal and metabolic comorbidities. Data on the epidemiology and clinical impact of the CKM syndrome in patients with atrial fibrillation (AF) are limited. We evaluated CKM domains and their impact in a real-world cohort of patients with AF.
methodsFrom the prospective global GLORIA-AF Registry phase III study, we defined CKM domains according to cardiovascular, renal and metabolic comorbidities or conditions in patients with AF and CHA
results16,070 patients (age 70.1 ± 10.4 years, 45.2% females) were included; 1931 (12.0%) presented with all 3 CKM domains, with substantial geographical variation in the distribution of CKM domains. OAC use increased with the number of CKM domains (Odds Ratio [OR] and 95% Confidence Intervals [CI]: 1.40 [1.14-1.72] and 1.38 [1.07-1.78] for 2 vs. 0 and 3 vs. 0 CKM domains, respectively). Over a 3-year follow-up, the incidence of the primary composite outcome increased with the number of CKM domains, with highest hazard observed in patients with 3 domains (Hazard Ratio [HR] and 95%CI: 1.69 [1.20-2.37]). Among groups of CKM domains, those characterized by the kidney domain showed the highest association with the risk of clinical outcomes.
conclusionsIn patients with AF, CKM domains are commonly found, and their prevalence is heterogeneous across geographical regions. CKM syndrome influences OAC use and had detrimental prognostic effects, with an increasing risk of all-cause death and MACE as the burden of CKM domains increased.
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