Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients
<b>Background</b>: Cardiovascular–kidney–metabolic (CKM) syndrome, recently defined by the American Heart Association, encompasses the interplay between obesity, diabetes, chronic kidney disease, and cardiovascular disease. This study aimed to investigate the impact of CKM syndrome sever...
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MDPI AG
2025-03-01
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| author | Ronny Shabtai Marlon Villaga Gatuz Adam Folman Maguli S. Barel Rami Abu-Fanne Dmitry Abramov Mamas A. Mamas Ariel Roguin Ofer Kobo |
| author_facet | Ronny Shabtai Marlon Villaga Gatuz Adam Folman Maguli S. Barel Rami Abu-Fanne Dmitry Abramov Mamas A. Mamas Ariel Roguin Ofer Kobo |
| author_sort | Ronny Shabtai |
| collection | DOAJ |
| description | <b>Background</b>: Cardiovascular–kidney–metabolic (CKM) syndrome, recently defined by the American Heart Association, encompasses the interplay between obesity, diabetes, chronic kidney disease, and cardiovascular disease. This study aimed to investigate the impact of CKM syndrome severity on outcomes in patients with acute myocardial infarction (AMI). <b>Methods</b>: A retrospective analysis was conducted using the National Inpatient Sample database from 2016 to 2019. Adult patients hospitalized with AMI were stratified into CKM Stages 0–4 based on ICD-10 codes. Multivariable logistic regression models were used to examine associations between CKM stages and in-hospital procedures and outcomes. <b>Results</b>: The study analyzed 2,768,154 AMI cases. Advanced CKM stages were associated with older age and a higher proportion of males. Patients with severe CKM were more likely to undergo invasive procedures. Coronary angiography showed the strongest association in CKM Stage 4A (aOR: 6.86, 95% CI: 6.73–6.99, <i>p</i>-value < 0.001) and Stage 4B (aOR: 3.87, 95% CI: 3.80–3.95, <i>p</i>-value < 0.001). Similarly, the likelihood of PCI was highest in Stage 4A (aOR: 5.93, 95% CI: 5.79–6.08, <i>p</i>-value < 0.001) and Stage 4B (aOR: 4.14, 95% CI: 4.04–4.24, <i>p</i>-value < 0.001). Notably, patients with CKM Stage 0 demonstrated higher odds of adverse outcomes compared to other stages. <b>Conclusions</b>: This study reveals a complex relationship between CKM syndrome severity and AMI outcomes. Patients with advanced CKM stages were more likely to undergo invasive procedures, and those without CKM risk factors unexpectedly showed worse outcomes. Among Stages 1–4B, no consistently graded association emerged between the CKM stage and adverse outcomes. These findings warrant further investigation into underlying mechanisms and long-term prognosis. |
| format | Article |
| id | doaj-art-24bf56e934ea4d608365c0bbd8c532ae |
| institution | OA Journals |
| issn | 2079-9721 |
| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-24bf56e934ea4d608365c0bbd8c532ae2025-08-20T02:28:28ZengMDPI AGDiseases2079-97212025-03-011349710.3390/diseases13040097Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million PatientsRonny Shabtai0Marlon Villaga Gatuz1Adam Folman2Maguli S. Barel3Rami Abu-Fanne4Dmitry Abramov5Mamas A. Mamas6Ariel Roguin7Ofer Kobo8Adelson School of Medicine, Ariel University, Ariel 4070000, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera 3820302, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera 3820302, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera 3820302, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera 3820302, IsraelDepartment of Cardiology, Linda Loma University Health, Linda Loma, CA 92354, USAKeele Cardiovascular Research Group, Keele University, Newcastle ST5 5BG, UKDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera 3820302, IsraelDepartment of Cardiology, Hillel Yaffe Medical Center, Hadera 3820302, Israel<b>Background</b>: Cardiovascular–kidney–metabolic (CKM) syndrome, recently defined by the American Heart Association, encompasses the interplay between obesity, diabetes, chronic kidney disease, and cardiovascular disease. This study aimed to investigate the impact of CKM syndrome severity on outcomes in patients with acute myocardial infarction (AMI). <b>Methods</b>: A retrospective analysis was conducted using the National Inpatient Sample database from 2016 to 2019. Adult patients hospitalized with AMI were stratified into CKM Stages 0–4 based on ICD-10 codes. Multivariable logistic regression models were used to examine associations between CKM stages and in-hospital procedures and outcomes. <b>Results</b>: The study analyzed 2,768,154 AMI cases. Advanced CKM stages were associated with older age and a higher proportion of males. Patients with severe CKM were more likely to undergo invasive procedures. Coronary angiography showed the strongest association in CKM Stage 4A (aOR: 6.86, 95% CI: 6.73–6.99, <i>p</i>-value < 0.001) and Stage 4B (aOR: 3.87, 95% CI: 3.80–3.95, <i>p</i>-value < 0.001). Similarly, the likelihood of PCI was highest in Stage 4A (aOR: 5.93, 95% CI: 5.79–6.08, <i>p</i>-value < 0.001) and Stage 4B (aOR: 4.14, 95% CI: 4.04–4.24, <i>p</i>-value < 0.001). Notably, patients with CKM Stage 0 demonstrated higher odds of adverse outcomes compared to other stages. <b>Conclusions</b>: This study reveals a complex relationship between CKM syndrome severity and AMI outcomes. Patients with advanced CKM stages were more likely to undergo invasive procedures, and those without CKM risk factors unexpectedly showed worse outcomes. Among Stages 1–4B, no consistently graded association emerged between the CKM stage and adverse outcomes. These findings warrant further investigation into underlying mechanisms and long-term prognosis.https://www.mdpi.com/2079-9721/13/4/97cardiovascular–kidney–metabolic syndromeacute myocardial infarctionrisk factorsoutcomes |
| spellingShingle | Ronny Shabtai Marlon Villaga Gatuz Adam Folman Maguli S. Barel Rami Abu-Fanne Dmitry Abramov Mamas A. Mamas Ariel Roguin Ofer Kobo Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients Diseases cardiovascular–kidney–metabolic syndrome acute myocardial infarction risk factors outcomes |
| title | Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients |
| title_full | Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients |
| title_fullStr | Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients |
| title_full_unstemmed | Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients |
| title_short | Impact of Cardiovascular–Kidney–Metabolic Syndrome Staging on Myocardial Infarction Outcomes: A Retrospective Analysis of 2.7 Million Patients |
| title_sort | impact of cardiovascular kidney metabolic syndrome staging on myocardial infarction outcomes a retrospective analysis of 2 7 million patients |
| topic | cardiovascular–kidney–metabolic syndrome acute myocardial infarction risk factors outcomes |
| url | https://www.mdpi.com/2079-9721/13/4/97 |
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