Prognostic value of the cardiometabolic index for cardiovascular outcomes in patients with type 2 diabetes mellitus

CK Zeng, Maojun Liu, Peiqi Tang, Ying Xin, Xinqun Hu

Background The Cardiometabolic Index (CMI) serves as a measurable indicator capable of concurrently reflecting the presence of metabolic disorders and the status of central obesity. The aim of this study is to evaluate the association between the CMI and the risk of developing major adverse cardiovascular events (MACEs) and all-cause mortality in patients with type 2 diabetes mellitus (T2DM). Methods This post-hoc analysis included 10,094 participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study and the ACCORD Follow-up study with baseline CMI data. The natural logarithm (ln) of each CMI measurement was computed. Univariate and multivariate Cox proportional hazard regression analyses were conducted to examine the relationship between CMI and the risk of MACEs and all-cause mortality. The incremental predictive value of CMI was further assessed. Results Over a median follow-up period of 8.82 years, 1,791 (17.74%) participants experienced MACEs, and 1,914 (18.96%) all-cause mortality were recorded. After adjusting for traditional cardiovascular risk factors, multivariate Cox proportional hazards regression analysis demonstrated a significant association between CMI and the risk of MACEs and all-cause mortality. Incorporating CMI into the conventional risk model improved the predictive efficacy for MACEs and all-cause mortality. Conclusions Elevated CMI is associated with an increased risk of MACEs and all-cause mortality in patients with T2DM. Furthermore, CMI improves the predictive performance for MACEs and all-cause mortality risk in this patient population.