{"id":"d289606f32c6","type":"article","url":"https://hartvaat.nl/2026/10/01/ckm-multimorbiditeit-verhoogt-sterfterisico-bij-hartfalen-chinese-registry/","title":"CKM-multimorbiditeit verhoogt sterfterisico bij hartfalen — Chinese registry","title_en":"Cardiovascular-Kidney-Metabolic Overlaps, Clinical Outcomes, and Medications Among Patients With Heart Failure: Results From the Chinese Cardiovascular Association Database-Heart Failure Center Registry.","category":"chronische nierziekte","category_label":"Nierziekte","professions":["cardioloog","internist"],"tags":[],"journal":"MedComm","doi":"10.1002/mco2.71008","source_url":"https://doi.org/10.1002/mco2.71008","authors":["Xiang Wang","Jingkuo Li","Yi Li","Lubi Lei","Wei Wang","Xuyang Meng","Chenxi Xia","Chenguang Yang","Lihua Zhang","Yuhua Liao","Weimin Li","Yugang Dong","Xinli Li","Jingmin Zhou","Jiefu Yang","Fang Wang"],"significance":5,"published":"2026-10-02","source_date":"2026-10-01","image":"","kennis":["https://hartvaat.nl/kennis/nierziekte/nierziekte-en-cardiovasculair-risico/","https://hartvaat.nl/kennis/cardiometabool/diabetes-en-cardiovasculair-risico/"],"congress":"","summary_en":"A registry study of 126,524 Chinese heart failure patients demonstrates that cardiovascular-kidney-metabolic (CKM) multimorbidity is highly prevalent and significantly worsens prognosis. Patients with all three CKM conditions (ASCVD, CKD, and type 2 diabetes) faced a 2.43-fold higher risk of one-year all-cause mortality compared to those without CKM conditions. While guideline-directed medical therapy (GDMT) reduced absolute mortality rates, it did not attenuate the relative risk associated with higher CKM burden. These findings reinforce the importance of early risk stratification and comprehensive management of overlapping metabolic and renal conditions in heart failure care.","created":"2026-09-26T00:56:10Z","updated":"2026-09-26T00:56:11Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Een cohortstudie van 126.524 Chinese hartfalenpatiënten toont aan dat multimorbiditeit binnen het Cardiovascular-Kidney-Metabolic (CKM)-syndroom veel voorkomt en de prognose aanzienlijk verslechtert. Patiënten met alle drie de CKM-condities (ASCVD, CKD en type 2-diabetes) hadden een 2,43 keer hoger risico op overlijden binnen één jaar vergeleken met patiënten zonder CKM-condities. Hoewel patiënten die guideline-gebaseerde medicamenteuze therapie (GDMT) gebruikten een lager absoluut sterfterisico hadden, veranderde deze therapie niet de relatieve risicostijging door de CKM-belasting. Voor de klinische praktijk onderstreept dit de noodzaak van vroegtijdige identificatie en intensieve risicomanagement bij hartfalenpatiënten met meerdere CKM-condities.","abstract_original":"Cardiovascular-kidney-metabolic (CKM) multimorbidity is common among patients with heart failure (HF), but its prognostic impact in Chinese patients remains largely unclear. We examined the relationship of CKM multimorbidity with adverse outcomes and its interaction with guideline-directed medical therapy (GDMT) in patients with HF. We classified hospitalized patients with HF by CKM-condition count (atherosclerotic cardiovascular disease [ASCVD], chronic kidney disease [CKD], and type 2 diabetes [T2D]). Cox models assessed 1-year all-cause death, cardiovascular (CV) death, and rehospitalizations. Among patients with HF with reduced ejection fraction (HFrEF), subgroup analyses were conducted by GDMT use. Among 126,524 patients, 66.4% had at least one CKM condition and 5.1% had all three. All-cause death increased with CKM burden; three conditions conferred the highest risk (adjusted hazard ratio 2.43, 95% confidence interval [CI] 2.20-2.69) versus no CKM conditions. Associations were stronger in HFrEF. Although GDMT recipients had lower absolute death rates, associations of CKM multimorbidity with all outcomes were generally consistent regardless of GDMT use. CKM multimorbidity is common in Chinese patients hospitalized with HF and is associated with a worse prognosis. Although GDMT lowered absolute death rates, it did not substantially modify the relative associations between CKM multimorbidity and subsequent clinical outcomes."}