美国乳腺癌女性的生命必需的8项指标与心血管疾病事件
Life's Essential 8 and Incident Cardiovascular Disease in U.S. Women With Breast Cancer.
作者信息
Wadden Elena, Vasbinder Alexi, Yogeswaran Vidhushei, Shadyab Aladdin H, Saquib Nazmus, Sun Yangbo, Warsinger Martin Lisa, Mazhari Ramesh, Manson JoAnn E, Stefanick Marcia, Barac Ana, Simon Michael S, Reding Kerryn, Cheng Richard K
机构信息
Department of Medicine, University of Washington, Seattle, Washington, USA.
Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, Washington, USA.
出版信息
JACC CardioOncol. 2024 Aug 27;6(5):746-757. doi: 10.1016/j.jaccao.2024.07.008. eCollection 2024 Oct.
BACKGROUND
Relationships between lifestyle risk factors and cardiovascular disease (CVD) risk in women with breast cancer (BC) are underexplored.
OBJECTIVES
To evaluate the incidence of CVD in relation to the Life's Essential 8 (LE8) score among women with BC.
METHODS
Data from the Women's Health Initiative were utilized. The primary exposure was the LE8 score assessed prior to BC diagnosis. The LE8 score was stratified into low (0-59), moderate (60-79), and high (80-100) cardiovascular health (CVH). The primary endpoint was a composite of incident CVD events, which included coronary heart disease, defined as myocardial infarction along with coronary revascularization, CVD death, and stroke. We calculated the cumulative incidence of CVD and estimated hazard ratios.
RESULTS
Among 7,165 participants, the median age was 70.1 years at BC diagnosis. The mean LE8 score was 62.0 ± 12.2. Over a median follow-up period of 6 years, 490 composite CVD events occurred. The risk of CVD events was highest for low CVH compared with moderate and high CVH. Compared with low CVH, the hazard ratio for incident CVD was 0.57 (95% CI: 0.46-0.69) for moderate CVH and 0.34 (95% CI: 0.20-0.59) for high CVH. LE8, in conjunction with age, provided a C-statistic of 0.74 for the composite risk of CVD.
CONCLUSIONS
Higher LE8 scores were associated with a lower risk of incident CVD among women with BC in the United States.
背景
乳腺癌（BC）女性的生活方式风险因素与心血管疾病（CVD）风险之间的关系尚未得到充分研究。
目的
评估BC女性中与生命必需8要素（LE8）评分相关的CVD发病率。
方法
利用了妇女健康倡议的数据。主要暴露因素是在BC诊断之前评估的LE8评分。LE8评分被分为低（0-59）、中（60-79）和高（80-100）心血管健康（CVH）水平。主要终点是CVD事件的复合终点，包括冠心病（定义为心肌梗死以及冠状动脉血运重建）、CVD死亡和中风。我们计算了CVD的累积发病率并估计了风险比。
结果
在7165名参与者中，BC诊断时的中位年龄为70.1岁。平均LE8评分为62.0±12.2。在中位随访期6年期间，发生了490例复合CVD事件。与中、高CVH相比，低CVH的CVD事件风险最高。与低CVH相比，中CVH发生CVD的风险比为0.57（95%CI：0.46-0.69），高CVH为0.34（95%CI：0.20-0.59）。LE8与年龄相结合，对CVD复合风险的C统计量为0.74。
结论
在美国，较高的LE8评分与BC女性发生CVD的风险较低相关。
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