Cardiovascular-Kidney-Metabolic syndrome predicts the development of cardiovascular events in patients with rheumatoid arthritis: a 10-years prospective analysis from the CARMA cohort.

Autores de IIS La Fe

• 

  José Andrés Román Ivorra

  Autor

Participantes ajenos a IIS La Fe

• González-Juanatey C
• Llorca J
• Castañeda S
• Ferraz-Amaro I
• García-Gómez C
• González-Gay MÁ
• onbehalf of the CARMA Project Collaborative Group

Grupos

• Reumatología

Abstract

OBJECTIVE: To analyze the prevalence of cardiovascular-kidney-metabolic (CKM) syndrome and the relationship with cardiovascular (CV) events in rheumatoid arthritis (RA) patients from the CARdiovascular in RheuMAtology (CARMA) project followed prospectively for 10 years. METHODS: Between July 2010 and January 2012, patients with RA and a comparison cohort of individuals without inflammatory diseases (controls) were recruited from 67 hospitals across Spain. CKM stage at recruitment was classified according to the American Heart Association consensus definition. Cox proportional hazards models adjusted for age and sex were used to evaluate the association between CKM stage and the composite outcome of CV events or all-cause mortality at 10-year follow-up. RESULTS: The study comprised 704 patients with RA and 604 controls followed prospectively for 10 years. The distribution of CKM stages differed significantly between two groups. Controls were more frequently classified in CKM stages 0 and 1, whereas RA patients predominated in advanced stages, particularly CKM stages 3 and 4 (p < 0.001). The incidence of CV events or all-cause mortality increased markedly with advancing CKM stage in both RA patients and controls. CKM stage 4 was associated with a significantly increased risk of composite outcome compared with CKM stage 2 in RA patients (Hazard ratio [HR] 3.90; 95% confidence interval [CI] 2.29-6.64) and controls (HR 5.22; 95% CI 2.39-11.40). RA patients classified as CKM stage 2 experienced a significantly higher risk of adverse composite outcome compared with controls at the same CKM stage (HR 2.40; 95% CI 1.42-4.05, p < 00.1). CONCLUSIONS: CKM syndrome has a high prevalence and is a determinant of CV outcomes in patients with RA.

Copyright © 2026 The Author(s). Published by Elsevier Inc. All rights reserved.

Keywords

• Cardiovascular events; Cardiovascular risk; Cardiovascular-kidney-metabolic syndrome; Rheumatoid arthritis