Evidence map›Paper›PMID 42089501›Full record

ArticleJACC. Asia2026

Cardio-Kidney-Metabolic Phenotypes and Adverse Clinical Outcomes in Patients With Atrial Fibrillation.

Jung-Chi Hsu, Chih-Kuo Lee, Yen-Yun Yang, Shu-Lin Chuang, Jen-Kuang Lee, Fu-Chun Chiu

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Article in JACC. Asia, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Jung-Chi HsuDivision of Cardiology, Department of Internal Medicine, National Taiwan University Jinshan Branch, New Taipei City, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: cactus146@gmail.com.
Chih-Kuo LeeDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Yen-Yun YangDepartment of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
Shu-Lin ChuangDepartment of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
Jen-Kuang LeeDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Laboratory Medicine, National Taiwan University College of Medicine, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Research, National Taiwan University Hospital, Taipei, Taiwan.
Fu-Chun ChiuDivision of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe prognostic impact of distinct cardio-kidney-metabolic (CKM) phenotypes on outcomes in atrial fibrillation (AF) remains unclear.

objectivesThe study sought to characterize CKM phenotypes and burden in AF and evaluate associations with clinical outcomes, exploring body mass index (BMI)-related heterogeneity.

methodsThis retrospective cohort study included 48,810 adults with AF (2014-2022). Patients were classified by CKM burden and phenotypes. Multivariable Cox and Fine-Gray models were used for heart failure hospitalization (HHF), transient ischemic attack/ischemic stroke, major adverse kidney events (MAKE), major adverse cardiovascular events (MACE), and all-cause mortality.

resultsThe median follow-up duration was 3.14 years (Q1-Q3: 1.04-6.10 years). The kidney-only phenotype carried the highest risks of all-cause mortality (adjusted HR [aHR]: 2.04; 95% CI: 1.95-2.14; P < 0.001) and MAKE (aHR: 2.07; 95% CI: 1.99-2.16; P < 0.001). The cardio-kidney phenotype also conferred prominent risks for all-cause mortality (aHR: 1.56; 95% CI: 1.44-1.70; P < 0.001) and MAKE (aHR: 1.74; 95% CI: 1.61-1.88; P < 0.001). For MACE, cardiovascular-only (aHR: 1.61; 95% CI: 1.45-1.79; P < 0.001) and cardiometabolic (aHR: 1.57; 95% CI: 1.42-1.74; P < 0.001) phenotypes showed strongest associations. For HHF, kidney-metabolic (subdistribution HR [sHR]: 1.29; 95% CI: 1.13-1.47; P < 0.001) and metabolic-only (sHR: 1.26; 95% CI: 1.15-1.37; P < 0.001) phenotypes showed largest increases. Underweight (BMI <18.5 kg/m

conclusionsCKM phenotypes stratify multisystem risks in AF. Kidney domain involvement identifies patients at highest risk for mortality and MAKE, while metabolic phenotypes are strongly associated with HHF. BMI further differentiates risk, with underweight status driving mortality and renal adverse events.

Indexed as

atrial fibrillationcardio-kidney-metabolic syndromemajor adverse cardiovascular eventsmajor adverse kidney eventsmultimorbidityobesity paradox

Identifiers

PMID42089501
PMCPMC13153914

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.