Search

Background: Cardiovascular-Kidney-Metabolic syndrome reflects the complex interplay between metabolic risk factors, cardiovascular and chronic kidney disease. Differences in disease burden by demographics, social determinants of health, and mortality are not well characterized., Methods: Data from adults who completed the National Health and Nutrition Examination Survey between 2011-2018 were used to estimate age-adjusted prevalence and 95% confidence intervals (CI) for Cardiovascular-Kidney-Metabolic syndrome stages. Joinpoint regression was used to identify linear trends. Kaplan-Meier curves were used to examine all-cause mortality risk by stages., Results: Among 8,474 adults in the study, the median age was 46.8 years, 49.1% were male, and 65.0% were non-Hispanic White. Age-adjusted prevalence of stages 0-4 were 11.2%, 28.1%, 47.4%, 5.3%, and 8.1%, respectively. The highest proportion of stage 4 was among adults aged ≥60 years, males, and non-Hispanic Black individuals. The advanced stages 3-4 was associated with lower educational attainment, income, and employment and higher mortality with a crude death rate of 188.8 per 1,000 person-years., Conclusion: Approximately 13% of adults were in advanced stages, which disproportionately affects non-Hispanic Black adults and increased over time. These results provide a roadmap for targeted intervention strategies., Competing Interests: Declaration of competing interest All authors (Ji-Eun Kim, Jungnam Joo, Kayode O. Kuku, Carolina Downie, Maryam Hashemian, Tiffany M. Powell-Wiley, Joseph J. Shearer, and Véronique L. Roger) declare that there are no conflicts of interest related to this work., (Copyright © 2025. Published by Elsevier Inc.)

Background: Higher total serum cholesterol is associated with lower mortality in heart failure. Evaluating associations between lipoprotein subfractions and mortality among people with heart failure may provide insights into this observation., Methods: We prospectively enrolled a community cohort of people with heart failure from 2003 to 2012 and assessed vital status through 2021. Plasma collected at enrollment was used to measure lipoprotein subfractions via nuclear magnetic resonance spectroscopy. A composite score of 6 lipoprotein subfractions was generated using the lipoprotein insulin resistance index (LP-IR) algorithm. Using covariate-adjusted proportional hazards regression models, we evaluated associations between LP-IR score and all-cause mortality., Results: Among 1382 patients with heart failure (median follow-up 13.9 years), a one-standard-deviation (SD) increment in LP-IR score was associated with lower mortality (hazard ratio [HR] 0.93; 95% confidence interval [CI], 0.97-0.99). Among LP-IR parameters, mean high-density lipoprotein (HDL) particle size was significantly associated with lower mortality (HR per 1-SD decrement in mean HDL particle size = 0.83; 95% CI, 0.78-0.89), suggesting that the inverse association between LP-IR score and mortality may be driven by smaller mean HDL particle size., Conclusions: LP-IR score was inversely associated with mortality among patients with heart failure and may be driven by smaller HDL particle size., (Published by Elsevier Inc.)