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Background Steatotic liver disease (SLD) is closely associated with cardiometabolic factors, but whether the cardiovascular-kidney-metabolic (CKM) stage can stratify the risk of cardiovascular and liver-related events (LREs) across SLD subtypes remains unclear.Methods To examine the associations between CKM stage and risk of major adverse cardiovascular events (MACEs) and LREs in SLD and its subtypes.In the UK Biobank prospective study, participants with SLD were classified into MASLD, MetALD, and ALD subtypes (IDDF2026-ABS-0303 Figure 1). The primary outcomes were incident MACEs and LREs, assessed overall and by subtypes. We analyzed the contribution of CKM stages to these clinical outcomes. Associations were evaluated using Cox models, Kaplan-Meier curves, and population-attributable risks (PARs).Results Over a mean follow-up of ~14 years, 21,734 MACEs (17.1%) and 2,747 LREs (2.0%) occurred among 142,824 individuals with SLD. Higher CKM stage was associated with an increased risk of MACEs and LREs, with adjusted-HRs for MACEs ranging from 1.37 (95% CI 1.31-1.44) to 2.96 (2.62-3.34) and for LREs from 1.23 (1.07-1.41) to 2.52 (2.15-2.94) for CKM stages 2 through 4 compared with stages 0-1 ( IDDF2026-ABS-0303 Figure 2). SLD subtypes also showed a similar trend for both outcomes (IDDF2026-ABS-0303 Figure 3, IDDF2026-ABS-0303 Figure 4). Obesity and hypertension were the leading contributors to both outcomes (PAR up to 15.9% and 13.7%), whereas diabetes contributed more prominently to LREs than to MACEs (12.6% vs. 6.0%) (IDDF2026-ABS-0303 Figure 5).Conclusions Higher CKM stage is closely associated with increased long-term risk of MACEs and LREs in SLD. Obesity, hypertension, and diabetes are the main contributors to LREs, whereas for MACEs, obesity and hypertension are the primary contributors.Abstract IDDF2026-ABS-0303 Figure 1Abstract IDDF2026-ABS-0303 Figure 2Abstract IDDF2026-ABS-0303 Figure 3Abstract IDDF2026-ABS-0303 Figure 4Abstract IDDF2026-ABS-0303 Figure 5