Lee So-Ryoung, Choi Eue-Keun, Park Sang-Hyeon, Lee Seung-Woo, Han Kyung-Do, Oh Seil, Lip Gregory Y H
Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea.
Front Cardiovasc Med. 2022 Jul 4;9:885016. doi: 10.3389/fcvm.2022.885016. eCollection 2022.
Little is known regarding the risk of clinical outcomes depending on the clustering of lifestyle behaviors after atrial fibrillation (AF) diagnosis. This study evaluated the association between a cluster of healthy lifestyle behaviors and the risk of adverse outcomes in patients with AF.
Using the Korean National Insurance Service database, patients who were newly diagnosed with AF between 2009 and 2016 were included. A healthy lifestyle behavior score (HLS) was calculated by assigning 1 point each for non-current smoking, for non-drinking, and for performing regular exercise from the self-reported questionnaire in health examinations. The primary outcome was defined as major adverse cardiovascular event (MACE), including ischemic stroke, myocardial infarction, and hospitalization for heart failure.
A total of 208,662 patients were included; 7.1% in HLS 0, 22.7% in HLS 1, 58.6% in HLS 2, and 11.6% in HLS 3 groups. Patients with HLS 1, 2, and 3 were associated with a lower risk of MACE than those with HLS 0 (adjusted hazard ratio [95% confidence interval (CI)]: 0.788 [0.762-0.855], 0.654 [0.604-0.708], and 0.579 [0.527-0.636], respectively). After propensity score weighting, consistent results were observed. The risk reduction of healthy lifestyle combinations was consistently observed in various subgroups, regardless of the CHADS-VASc score and oral anticoagulant use.
Increased number of healthy lifestyle behaviors was significantly associated with lower MACE risk in patients with new-onset AF. These findings support the promotion of a healthy lifestyle to reduce the risk of adverse events in patients with AF.
关于心房颤动（AF）诊断后生活方式行为聚集对临床结局风险的影响，人们了解甚少。本研究评估了健康生活方式行为聚集与AF患者不良结局风险之间的关联。
利用韩国国民健康保险服务数据库，纳入2009年至2016年间新诊断为AF的患者。通过对健康检查自我报告问卷中的非当前吸烟、非饮酒和定期锻炼各赋1分，计算健康生活方式行为评分（HLS）。主要结局定义为主要不良心血管事件（MACE），包括缺血性卒中、心肌梗死和因心力衰竭住院。
共纳入208,662例患者；HLS 0组占7.1%，HLS 1组占22.7%，HLS 2组占58.6%，HLS 3组占11.6%。与HLS 0组患者相比，HLS 1、2和3组患者发生MACE的风险较低（调整后风险比[95%置信区间（CI）]：分别为0.788[0.7,62 - 0.855]、0.654[0.604 - 0.70, 和0.579[0.527 - 0.636]）。倾向评分加权后，观察到一致的结果。无论CHADS-VASc评分和口服抗凝剂使用情况如何，在各个亚组中均持续观察到健康生活方式组合降低风险的情况。
新发AF患者中，健康生活方式行为数量增加与较低的MACE风险显著相关。这些发现支持推广健康生活方式以降低AF患者不良事件的风险。
