ArticleBMC cardiovascular disorders2025
Association between 10-year atherosclerotic cardiovascular disease risk score and incident cardiovascular events across stages 0-3 of cardiovascular-kidney-metabolic syndrome: evidence from the China health and retirement longitudinal study (CHARLS).
Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Joint association of high-sensitivity C-reactive protein and cumulative atherogenic index of plasma with cardiovascular disease risk in CKM syndrome stages 0-3: a prospective cohort study.BMC cardiovascular disorders · 2026Article
- Cardiovascular-kidney-metabolic syndrome: a comprehensive review of pathophysiology, epidemiology, diagnosis, and management.Cardiovascular diabetology · 2026Review
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11 authors.
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Abstract
backgroundThe cardiovascular-kidney-metabolic (CKM) syndrome framework integrates cardiometabolic risks. However, longitudinal evidence on the association between atherosclerotic cardiovascular disease 10-year risk (ASCVD10 year) scores and cardiovascular events across CKM syndrome stages remains limited in large aging populations.
methodsWe analyzed data from 4,565 adults aged ≥ 45 years in the China Health and Retirement Longitudinal Study (CHARLS). ASCVD10 year scores were calculated using the China-PAR model at baseline (2012) and follow-up (2015), with cumulative risk scores derived accordingly. Participants were stratified into four trajectory clusters via k-means clustering based on ASCVD score dynamics. Logistic regression, restricted cubic spline models, subgroup analysis, and mediation analyses were conducted to assess associations and underlying pathways.
resultsHigher baseline and cumulative ASCVD10 year scores were significantly associated with increased risks of cardiovascular disease (CVD), heart disease, and stroke across CKM stages 0-3 (all P < 0.0001). Compared to the low-risk cluster, the highest-risk cluster exhibited a > 4-fold increased CVD risk (OR = 4.12, 95% CI: 2.81-6.02). Nonlinear associations were observed for CVD and heart disease, with inflection points indicating stronger effects at lower ASCVD ranges. Subgroup analyses revealed stronger associations in individuals ≤ 65 years, females, and those with hypertension or diabetes. Mediation analyses identified HbA1c, fasting glucose, and the TyG index as partial mediators, accounting for 3-6% of the total effect.
conclusionsASCVD10 year scores, particularly cumulative exposure, are robust predictors of cardiovascular events across early CKM stages in middle-aged and older adults. These findings support the utility of longitudinal ASCVD10 year scores in preventive cardiometabolic strategies.
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