ArticleThe Korean journal of internal medicine2025
Long-term clinical outcome and risk stratification across stages of cardiovascular-kidney-metabolic syndrome in a nationwide cohort.
Article in The Korean journal of internal medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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The trial behind it
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Who cites it
5 citing papers in PubMed.
- From Specialty Silos to Integrated Care: A Korean Initiative for Cardiovascular-Kidney-Metabolic Health.Electrolyte & blood pressure : E & BP · 2026Article
- Optimizing early triage for subclinical cardiovascular-kidney-metabolic syndrome: longitudinal associations, incremental value, and clinical utility of nine insulin resistance surrogates.Cardiovascular diabetology · 2026Article
- Cardiovascular-Kidney-Metabolic (CKM) Syndrome Staging and Relevance to Precision Nutrition.Nutrients · 2026Review
- Nationwide Big Data Studies of Endocrine Diseases Using the Korean National Health Information Database: Research Trends and Standardization of Operational Definitions.Endocrinology and metabolism (Seoul, Korea) · 2026Review
- Uric acid-based nutritional and inflammatory biomarkers for predicting cardiovascular-kidney-metabolic syndrome and mortality: a population-based study with external validation.Frontiers in endocrinology · 2026Article
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Authors and funding
8 authors.
Funding
Abstract
BACKGROUND/
aimsCardiovascular-kidney-metabolic (CKM) syndrome is a continuum of metabolic, cardiovascular, and kidney dysfunctions. This study aimed to evaluate the association between CKM stages and the risk of adverse composite clinical outcomes.
methodsThis retrospective cohort study used data from the Korean National Health Insurance Database and included 1,497,913 individuals who underwent at least two health checkups between 2009 and 2012. The participants were classified into CKM stages (0-4), and the primary outcome was a composite of all-cause death, myocardial infarction, ischemic stroke, hemorrhagic stroke, and hospitalization for heart failure.
resultsThe distribution of CKM stages was 17.4% (stage 0), 15.7% (stage 1), 57.6% (stage 2), 6.3% (stage 3), and 3.1% (stage 4). The incidence rate of primary outcomes increased progressively across the CKM stages, from 2.07 per 1,000 person- years in stage 0 to 40.70 per 1,000 person-years in stage 4. Compared with stage 0, the adjusted hazard ratios (HRs) for the primary outcome were significantly elevated: stage 1 (HR 1.09; 95% confidence interval [CI] 1.06-1.13; p < 0.001), stage 2 (HR 1.36; 95% CI 1.32-1.39; p < 0.001), stage 3 (HR 1.72; 95% CI 1.67-1.77; p < 0.001), and stage 4 (HR 2.70; 95% CI 2.62-2.79; p < 0.001).
conclusionA higher CKM stage was associated with a progressive increase in the risk of all-cause mortality and major cardiovascular events. Clinicians may benefit from prioritizing the early identification of high-risk individuals and implementing targeted management strategies based on CKM staging to improve long-term adverse outcomes.
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