Association between cardiovascular-kidney-metabolic syndrome, inflammatory biomarkers, and cardiovascular outcomes: Insights from the MESA study.

IF 5.7 2区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Atherosclerosis Pub Date : 2025-10-02 DOI:10.1016/j.atherosclerosis.2025.120521

Muhammad Imtiaz Ahmad, Parag Chevli, Saeid Mirzai, Jared A Spitz, Garima Sharma, Joao Lima, Khurram Nasir, Michael J Blaha, Neha J Pagidipati, Roger S Blumenthal, Michael D Shapiro

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引用次数: 0

Abstract

Background: This study investigated the association between cardiovascular-kidney-metabolic (CKM) syndrome stages 0-3 and atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF), as well as whether this association varies by interleukin-6 and high-sensitivity C-reactive protein (hsCRP).

Methods: 6579 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) were included. Restricted mean survival time (RMST) differences in ASCVD and HF-free survival by CKM syndrome stage, stratified by inflammatory markers, were estimated.

Results: Over a median follow-up of 17.5 years (IQR: 10.5-18.4 years), participants with CKM stage 3 demonstrated significantly shorter ASCVD-free survival compared to stage 0 (-1.94 years; 95 % CI: -2.27, -1.61). Subgroup analysis by IL-6 levels demonstrated differential RMST across CKM stages, with participants having above-median IL-6 levels showing greater survival reduction (-2.5 years; 95 % CI: -3.50, -1.85) than those with below-median levels (-1.46 years; 95 % CI: -1.84, -1.07) (interaction p = 0.002). For heart failure outcomes, categorization by IL-6 levels displayed similar patterns by CKM stage (interaction p = 0.006). Among participants with elevated IL-6, both CKM stages 2 and 3 were associated with reduced HF-free survival (-0.40 years [95 % CI: -0.69, -0.01], and -0.87 years [95 % CI: -1.18, -0.55], respectively). Conversely, participants with lower IL-6 levels showed a significant reduction in HF-free survival only at the CKM stage 3 level (-0.36 years: 95 % CI: -0.57, -0.14). hsCRP stratification yielded comparable results but without significant interactions for either cardiovascular outcome.

Conclusions: These findings suggest that systemic inflammation, as measured by IL-6, may modify the risk of ASCVD and HF associated with CKM syndrome. Therefore, IL-6 measurement could potentially refine risk stratification and prognosis of CKM syndrome stages. However, further studies are needed to assess the clinical relevance of this approach.

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心血管-肾脏代谢综合征、炎症生物标志物和心血管预后之间的关联：来自MESA研究的见解

背景：本研究探讨了心血管-肾代谢（CKM）综合征0-3期与动脉粥样硬化性心血管疾病（ASCVD）和心力衰竭（HF）之间的关系，以及这种关系是否因白细胞介素-6和高敏c反应蛋白（hsCRP）而异。方法：从多民族动脉粥样硬化研究（MESA）中纳入6579名参与者。通过炎症标记物分层，估计CKM综合征分期ASCVD和无hf生存期的限制平均生存时间（RMST）差异。结果：中位随访17.5年（IQR: 10.5-18.4年），CKM 3期患者的无ascvd生存期明显短于0期患者（-1.94年；95% CI: -2.27, -1.61）。IL-6水平的亚组分析显示了不同CKM分期的RMST差异，IL-6水平高于中位水平的参与者比低于中位水平的参与者（-1.46年，95% CI: -1.84, -1.07）显示出更大的生存减少（-2.5年，95% CI: -3.50, -1.85）（相互作用p = 0.002）。对于心力衰竭的结果，IL-6水平的分类与CKM分期相似（相互作用p = 0.006）。在IL-6升高的参与者中，CKM 2期和3期均与减少的无hf生存相关（分别为-0.40年[95% CI: -0.69, -0.01]和-0.87年[95% CI: -1.18, -0.55]）。相反，IL-6水平较低的参与者仅在CKM 3期水平上显示无hf生存显著减少（-0.36年：95% CI: -0.57, -0.14）。hsCRP分层产生了类似的结果，但对两种心血管结果没有显著的相互作用。结论：这些发现表明，通过IL-6测量的全身性炎症可能会改变与CKM综合征相关的ASCVD和HF的风险。因此，检测IL-6有可能改善CKM综合征分期的风险分层和预后。然而，需要进一步的研究来评估这种方法的临床相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Atherosclerosis 医学-外周血管病

CiteScore

9.80

自引率

3.80%

发文量

1269

审稿时长

36 days

期刊介绍： Atherosclerosis has an open access mirror journal Atherosclerosis: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atherosclerosis brings together, from all sources, papers concerned with investigation on atherosclerosis, its risk factors and clinical manifestations. Atherosclerosis covers basic and translational, clinical and population research approaches to arterial and vascular biology and disease, as well as their risk factors including: disturbances of lipid and lipoprotein metabolism, diabetes and hypertension, thrombosis, and inflammation. The Editors are interested in original or review papers dealing with the pathogenesis, environmental, genetic and epigenetic basis, diagnosis or treatment of atherosclerosis and related diseases as well as their risk factors.