CaReMap maps disease progression and mortality in cardio-renal-metabolic syndrome

The CaReMap observational cohort study examined disease coexistence, progression, and survival among 71,694 adults with established cardio-renal-metabolic conditions using an Italian Regional Epidemiological Repository. The selection period was 2017–2022. Incident patients, representing 31.8% of the cohort, had a first diagnosis of diabetes mellitus, heart failure, or chronic kidney disease after January 1, 2017; prevalent patients were classified by their morbidity status on that date. Analyses included Kaplan–Meier survival estimates and cumulative incidence of cause-specific events.

Among incident patients, those with heart failure had the highest probability of developing an additional diagnosis: 60.4% at six years. Patients with chronic kidney disease had the highest probability of death before a new diagnosis, at 43.3%. Among prevalent patients, those with both diabetes and heart failure had the highest cumulative incidence of further diagnoses, reaching 47.1% at six years. Heart failure and chronic kidney disease groups experienced the steepest declines in overall survival in both cohorts.

These findings may support risk stratification and integrated care pathways, while highlighting death as a substantial competing event when assessing disease progression. The observational design does not establish causality. Only the abstract was available, limiting assessment of diagnostic definitions, confounding, and applicability beyond the regional Italian population.