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Association between cumulative exposure to cardiometabolic index and risk of heart failure: a prospective cohort
Peng Fu1,2, Huancong Zheng3, Weiqiang Wu1
1Department of Cardiology, Second Affiliated Hospital of Shantou University Medical College, No. 69, Dongxia North Road, Jinping District, Shantou, Guangdong Province 515000, China.
Insights
High cumulative cardiometabolic index (CMI) significantly increases heart failure (HF) risk over time. Maintaining optimal CMI levels is crucial for preventing HF in the general population.
Area of Science:
- Cardiology
- Preventive Medicine
- Epidemiology
Background:
- High cardiometabolic index (CMI) is a known risk factor for heart failure (HF).
- The long-term impact of cumulative CMI exposure on incident HF requires further investigation.
Purpose of the Study:
- To examine the association between cumulative CMI exposure and the risk of developing incident HF.
- To assess the long-term impact of cumulative CMI on heart failure incidence in a large prospective cohort.
Main Methods:
- Utilized data from 44,773 participants in the Kailuan Study with baseline health examinations in 2006, 2008, and 2010.
- Calculated cumulative CMI and categorized it into quartiles; incident HF identified via medical records and death registries until December 2022.
- Employed Cox proportional hazards models to estimate hazard ratios and 95% confidence intervals for HF risk.
Main Results:
- Over a median 12.0-year follow-up, 1018 HF events occurred.
- Compared to the lowest quartile, cumulative CMI in the highest quartiles (Q2-Q4) showed significantly increased adjusted hazard ratios for HF (P for trend < 0.001).
- A significant interaction was found between cumulative CMI and diabetes (P = 0.043), but not with age, sex, or hypertension.
Conclusions:
- High cumulative cardiometabolic index is independently associated with an elevated risk of heart failure.
- Long-term monitoring and maintaining optimal CMI levels may be key strategies for early HF identification and prevention.
Introduction:
High cardiometabolic index (CMI) is a risk factor for heart failure (HF), but the long-term impact of cumulative CMI exposure on incident HF remains unclear. We examined the association between cumulative CMI and HF risk in a large prospective cohort.
Methods:
A total of 44 773 participants (mean age 53.1 ± 11.9 years; 78.6% men) from the Kailuan Study who attended three health examinations in 2006, 2008, and 2010 and were free of cardiovascular disease or cancer at baseline were included. Cumulative CMI was calculated as the weighted sum of mean CMI across time intervals and categorized into quartiles. Incident HF was identified through medical records and death registries until 31 December 2022. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals.
Results:
Over a median follow-up of 12.0 years (IQR 11.7-12.3), 1018 HF events occurred. Compared with the lowest quartile, adjusted hazard ratios (95% confidence intervals) were 1.18 (0.95-1.50), 1.32 (1.05-1.65), and 1.40 (1.11-1.76) for Q2-Q4 (P for trend < 0.001). A significant interaction was observed between cumulative CMI and diabetes (P = 0.043), but not with age, sex, or hypertension. Sensitivity analyses yielded consistent results.
Conclusion:
High cumulative CMI was independently associated with increased HF risk. Long-term monitoring and maintenance of an optimal CMI level may aid in early identification and prevention of HF in the general population.
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