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Associations were assessed using generalized ordered logistic regression, Cox proportional hazards models, and population attributable fractions (PAFs). Among 5752 participants (53.2% women; mean age: women 53.1 \u00b1 10.7, men 52.3 \u00b1 10.7 years), 580 CVD events (381 ASCVD) and 723 deaths occurred over 14.3 years. Cardiovascular\u2013kidney\u2013metabolic syndrome stage distribution differed by sex (men vs. women): 0 (9.9% vs. 26.1%), 1 (13.3% vs. 13.7%), 2 (62.6% vs. 56.8%), 3 (9.4% vs. 1.7%), and 4 (4.8% vs. 1.7%). Risk of CVD and ASCVD rose with higher CKM stage (vs. Stage 0), with HRs of 5.16 (95% CI, 2.61\u201310.19) and 3.82 (1.76\u20138.27) for Stage 3 in men, compared with 1.92 (0.91\u20134.04) and 1.95 (0.79\u20134.81) in women. For ACM, risk peaked at Stage 3 in women [3.43 (1.92\u20136.10)] and at Stage 4 in men [2.42 (1.27\u20134.64)]. Incremental PAFs peaked at Stage 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Cardiovascular\u2013kidney\u2013metabolic syndrome stages were associated with a stepwise increase in risk of CVD and ACM, with important sex-specific differences observed particularly for ACM. These findings support the relevance of CKM staging for cardiovascular risk stratification and prevention in the general population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwag394","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:17:30Z","timestamp":1785237450000},"source":"Crossref","is-referenced-by-count":0,"title":["Cardiovascular\u2013kidney\u2013metabolic syndrome and long-term risk of cardiovascular disease and all-cause mortality"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0816-1143","authenticated-orcid":false,"given":"Noushin Sadat","family":"Ahanchi","sequence":"first","affiliation":[{"name":"Department of Internal Medicine and Specialties, Internal Medicine, Fribourg Hospital and University of Fribourg , Chemin des Pensionnats 26, 1752 Villars-sur-Glane 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