Comparison of Risk Stratification Tools for Atherosclerotic Cardiovascular Disease and Cardiovascular–Kidney–Metabolic Syndrome in Primary Care

Abstract

Background/Objectives: Cardiovascular disease is the leading cause of death in Mexico; this is due to the high prevalence of chronic non-communicable diseases (NCDs), including obesity, type 2 diabetes mellitus (T2DM), systemic arterial hypertension (SAH), cardiovascular disease, chronic kidney disease (CKD), and dyslipidemia. Primary care physicians require a classification tool that enables them to gain a broader understanding of their patients’ risks, thereby allowing them to make more informed clinical decisions. This study compared risk stratification for atherosclerotic cardiovascular disease (ASCVD) and Cardiovascular–Kidney–Metabolic (CKM) syndrome in a primary care setting in Mexico. Methods: An observational, descriptive, cross-sectional study analyzed 500 patients with T2DM, SAH, dyslipidemia, and/or CKD. Two ordinal logistic regression models were developed using a Chi-square test, Kruskal–Wallis test, and tetrachoric, polychoric, polyserial, and Pearson correlations. Results: Associations were found between ASCVD risk and factors like sex, age, and T2DM; for CKM syndrome, the associations were with age, T2DM, and dyslipidemia. Interestingly, 22% of advanced CKM patients had a low ASCVD risk. Alcohol consumption showed a strong positive relationship (42%) with CKM stages, while there was a negative relationship (33%) with the glomerular filtration rate. Conclusions: The ASCVD risk classification effectively identifies cardiac conditions, but the CKM syndrome score provides a broader assessment of comorbidities at earlier stages. Key factors like age, hypertension, T2DM, and smoking are crucial for cardiovascular risk but less so for CKM syndrome, highlighting the need for a broader stratification of risk.