Progression in Cardiovascular-Kidney-Metabolic (CKM) Stages Over 7 Years in Mid-Life: The Dallas Heart Study
Abstract Body (Do not enter title and authors here): Introduction: While previous studies have quantified the community prevalence of Cardiovascular-Kidney-Metabolic (CKM) Stages, limited data exist regarding the expected progression of CKM Stages in mid-life.
Methods: Among participants in the population-sampled Dallas Heart Study (DHS) longitudinal cohort, we estimated the prevalence of CKM Stages at Visit 1 (DHS1; 2000-2002) and Visit 2 (DHS2, 2007–2009). Protocol measurements of body composition, lipids, fasting blood sugar, serum creatinine, NT-proBNP, hs-cTnT, urinary albumin and creatinine, coronary artery calcium by cardiac CT (CAC), and cardiac function and mass by cardiac MRI were conducted at both visits. To account for Visit 2 non-attendance, we performed additional sensitivity analysis using inverse probability of attrition weights (IPAW) with the following DHS1 variables as predictors of DHS2 attendance: age, sex, race, obesity, income, education level, eGFR, ejection fraction, cardiovascular risk score, and history of heart failure, coronary heart disease, or stroke.
Results: Among 2,991 participants at DHS1, 2030 also attended DHS2 and had an age of 44±10 years at DHS1 and 52±10 years at DHS2, 58% were female, and 50% reported non-Hispanic Black race/ethnicity. Over the median 6.8 (IQR 6.3-7.3) years between DHS1 and DHS2, the prevalence of CKM Stage 1 decreased from 14.7 to 10.8%; while the prevalence of CKM Stage 4 increased from 6% to 13%. Overall, 32% had progression in CKM Stage (Figure). Among the 280 (14%) participants who improved their CKM Stage, 206 (74%) derived from Stage 3 at DHS1, primarily meeting these criteria due to elevated troponin. Similar findings were observed in analyses incorporating IPAW to account for DHS2 non-attendance.
Conclusion: In a community-based cohort, CKM Stages progressed in nearly one-third over 7 years in mid-life. The prevalence of advanced CKM Stages (i.e., Stage 3 and 4) increased from 28% to 34%. The role and criteria of cardiac biomarkers in defining Stage 3 CKM warrant further study.
Shelbaya, Khaled
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Neeland, Ian
( University Hospitals - Case Western
, Cleveland
, Ohio
, United States
)
Ndumele, Chiadi
( JOHNS HOPKINS HOSPITAL
, Silver Spring
, Maryland
, United States
)
Shah, Amil
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Yang, Yimin
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Zeleke, Yinun
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Lamberson, Victoria
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Joshi, Parag
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Rohatgi, Anand
( UT SOUTHWESTERN
, Dallas
, Texas
, United States
)
Ayers, Colby
( UT Southwestern Medical Center
, Dallas
, Texas
, United States
)
Khera, Amit
( UT Southwestern
, Dallas
, Texas
, United States
)
De Lemos, James
( UT SOUTHWESTERN MEDICAL CTR
, Dallas
, Texas
, United States
)
Author Disclosures:
Khaled Shelbaya:DO have relevant financial relationships
;
Employee:Alexion Pharmaceuticals Inc:Active (exists now)
| Ian Neeland:DO have relevant financial relationships
;
Consultant:Boehringer Ingelheim:Past (completed)
; Advisor:MJH Life Sciences:Active (exists now)
; Advisor:Novo Nordisk:Past (completed)
; Speaker:Bayer:Active (exists now)
; Speaker:Eli Lilly:Active (exists now)
; Consultant:Eli Lilly:Past (completed)
; Speaker:Boehringer Ingelheim:Active (exists now)
| Chiadi Ndumele:DO NOT have relevant financial relationships
| Amil Shah:DO NOT have relevant financial relationships
| Yimin Yang:DO NOT have relevant financial relationships
| Yinun Zeleke:No Answer
| Victoria Lamberson:DO NOT have relevant financial relationships
| Parag Joshi:DO have relevant financial relationships
;
Research Funding (PI or named investigator):Novartis:Active (exists now)
; Consultant:New Amsterdam Pharma:Past (completed)
; Consultant:Kaneka:Past (completed)
; Consultant:Novartis:Past (completed)
; Research Funding (PI or named investigator):Kaneka:Past (completed)
; Research Funding (PI or named investigator):Eli Lilly:Active (exists now)
| Anand Rohatgi:DO have relevant financial relationships
;
Consultant:Raydel:Past (completed)
; Consultant:JP Morgan:Past (completed)
; Consultant:Johnson and Johnson:Past (completed)
; Other (please indicate in the box next to the company name):LabCorp:Active (exists now)
; Other (please indicate in the box next to the company name):Quest:Active (exists now)
; Research Funding (PI or named investigator):CSL Behring:Past (completed)
| Colby Ayers:DO have relevant financial relationships
;
Consultant:NIH:Active (exists now)
| Amit Khera:DO NOT have relevant financial relationships
| James de Lemos:DO have relevant financial relationships
;
Independent Contractor:Amgen, Inc.:Active (exists now)
; Independent Contractor:Verve:Active (exists now)
; Consultant:Siemen's:Past (completed)
; Independent Contractor:Jannsen:Active (exists now)
; Independent Contractor:Astra Zeneca:Past (completed)
; Independent Contractor:Merck:Active (exists now)
; Independent Contractor:Eli Lilli:Active (exists now)
; Independent Contractor:Varian:Active (exists now)
; Independent Contractor:Regerenon Pharmaceuticals:Active (exists now)
Tran Dieu Hien, Do Chau, Nguyen Thi Kim Chuc, Pham Ngoc Anh Vu, Phan Hoang Son, Phan Tri Cuong, Han Nguyen Le My, Nguyen Thi Huong Dung, Vo Le Y Nhi, Cao Doan Thi Bich Huyen, Tran Thanh Phong, Truyen Thien Tan Tri Tai, Tran Van Duong, Nguyen Ngoc Huyen, Pham Thanh Phong, Nguyen Minh Nghiem, Nguyen Van Khoa, Vo Phuc Dai, Le Hoang Phuc, Dinh Quang Minh Trí, Vu Loc, Kieu Doan Thi
