Association of cardiometabolic index and risk of stroke: A systematic review and meta-analysis

Stroke remains a leading cause of morbidity and mortality worldwide, contributing significantly to public health burdens. Cardiovascular and metabolic risk factors such as diabetes, hypertension, obesity, and dyslipidaemia are strongly associated with an increased risk of stroke. The cardio-metabolic index (CMI), which integrates these factors into a single measure, has emerged as a potential predictor of stroke. This systematic review and meta-analysis intended to examine the link between CMI and risk of stroke, offering an in-depth evaluation of its predictive value METHODS: A systematic search was conducted in PubMed, Embase, and Web of Science until 10 December 2024. The inclusion criteria focused on observational studies (cohort, cross-sectional, and case-control) that reported original data on the association of CMI and stroke risk. Data extraction was standardized, and quality was assessed using the Newcastle-Ottawa Scale. Meta-analysis was performed using a random effects model in R software version 4.4 RESULTS: From 545 articles initially retrieved, with 5 studies met inclusion criteria, encompassing over 100,000 participants. Meta-analysis showed a significant association between elevated CMI and stroke risk with a pooled RR of 1.66 (95 % CI: 1.25 to 2.20). A subgroup analysis of cohort studies yielded a pooled HR of 1.63 (95 % CI: 1.21 to 2.21). There was no significant heterogeneity across studies (I² = 0 %).

Our findings demonstrated a strong association between elevated CMI and an increased risk of stroke. CMI, by integrating multiple cardiovascular and metabolic factors, serves as a comprehensive predictor of stroke risk. Incorporating CMI into routine health screenings could enhance early identification and prevention efforts, ultimately aiding in the reduction of stroke incidence.