Higher EASIX was associated with greater all-cause and cardiovascular mortality in CKM stages 0-3, suggesting its potential role in clinical risk assessment warrants further validation.
Each one-unit increase in EASIX was independently associated with increased all-cause mortality in adults at CKM syndrome stages 0-3.
Each one-unit increase in EASIX was independently associated with increased cardiovascular mortality in adults at CKM syndrome stages 0-3.
Mortality associations between EASIX and both all-cause and cardiovascular death persisted after additional lifestyle adjustment.
CKM syndrome stage did not significantly modify the association between EASIX and mortality in the full cohort.
The study used EASIX, calculated from routine clinical laboratory values, as a measure of endothelial dysfunction in a large nationally representative cohort.
This research suggests that a simple blood test score called EASIX — calculated from three routine lab values (lactate dehydrogenase, creatinine, and platelet count) — can predict the risk of dying from any cause or from heart disease in people who have early-to-moderate cardiovascular-kidney-metabolic (CKM) syndrome. The study followed nearly 11,000 American adults for a median of about 8 years, and found that people with higher EASIX scores were significantly more likely to die, even after accounting for lifestyle factors. EASIX is thought to reflect how well the inner lining of blood vessels (the endothelium) is functioning, and endothelial dysfunction is a key mechanism linking heart disease, kidney disease, and metabolic conditions like diabetes. The practical implication is that EASIX could potentially serve as an inexpensive and accessible tool to identify people at higher risk of death among those with CKM syndrome, since it relies only on commonly ordered laboratory tests. The relationship between EASIX and all-cause mortality was linear (higher scores consistently meant higher risk), while the relationship with cardiovascular death was more complex and non-linear. Importantly, CKM syndrome stage alone did not change how strongly EASIX predicted mortality, suggesting EASIX adds risk information across a broad range of disease severity. This research was based on a large, nationally representative U.S. sample, which strengthens the generalizability of the findings. However, because it is an observational study, it cannot prove that endothelial dysfunction directly causes these deaths. The authors note that further validation studies are needed before EASIX could be adopted into routine clinical risk assessment for people with CKM syndrome.
Abudesimu A, Sun Z, Zhang G, Sun X, Peng X, Siti D, et al.. (2026). Endothelial dysfunction and long-term survival in cardiovascular-kidney-metabolic syndrome stages 0-3: An EASIX-based national cohort study.. Science progress. https://doi.org/10.1177/00368504261499186