Nguyen Xuan-Mai T, Li Yanping, Gong Yusi, Houghton Serena, Ho Yuk-Lam, Pyatt Mary, Treu Timothy, Li Ruifeng, Akinosho Kitan, Raghavan Sridharan, Gagnon David R, Gaziano John Michael, Wilson Peter W F, Cho Kelly
Million Veteran Program Boston Coordinating Center, VA Boston Healthcare System, Boston, Massachusetts.
Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.
JAMA Netw Open. 2024 Dec 2;7(12):e2447902. doi: 10.1001/jamanetworkopen.2024.47902.
The American Heart Association proposed Life's Essential 8 (LE8) as an enhanced measurement tool for cardiovascular health.
To examine the association of LE8 with risk of atherosclerotic cardiovascular disease (ASCVD) incidence and prognosis in veterans.
DESIGN, SETTING, AND PARTICIPANTS: This was a prospective cohort study of US veterans enrolled in the Department of Veterans Affairs (VA) Million Veteran Program (MVP) between 2011 and 2022. Data were analyzed from 2023 to 2024.
LE8 score ranged from 0 to 100, with higher score indicating better cardiovascular health.
The primary outcome was total ASCVD incidence in veterans without baseline ASCVD, and the secondary outcome was incidence of a major adverse cardiovascular event (MACE) among veterans with and without ASCVD at baseline.
A total of 413 052 veterans (mean [SD] age, 65.8 [12.1] years; 378 162 [91.6%] male) were included. Based on 1.7 million person-years of follow-up of 279 868 veterans without any ASCVD at baseline, 45 067 veterans had an ASCVD event during follow-up. Total LE8 score and each component LE8 factor score was associated with incident ASCVD in an inverse, linear, dose-response manner. For veterans without prior ASCVD, those with an LE8 score between 80 and 100 had lower risk of ASCVD compared with those with an LE8 score of 0 to 49 (adjusted hazard ratio [aHR], 0.36 [95% CI, 0.35-0.38]). Similarly, risk of MACE was significantly lower among veterans with an LE8 score of 80 to 100 regardless of baseline ASCVD status (with ASCVD: aHR, 0.52 [95% CI, 0.48-0.56]; without ASCVD: aHR, 0.14 [95% CI, 0.13-0.15]) compared with those with ASCVD and an LE8 score of 0 to 49.
In this cohort study of US veterans, higher LE8 scores were associated with significantly lower ASCVD incidence risk and lower likelihood of developing adverse cardiovascular events regardless of ASCVD status at baseline. These results support the utility of LE8 for health promotion and ASCVD prevention.
美国心脏协会提出了“生命的八大基本要素”（LE8）作为心血管健康的强化测量工具。
研究LE8与退伍军人动脉粥样硬化性心血管疾病（ASCVD）发病率及预后风险的关联。
设计、地点和参与者：这是一项对2011年至2022年期间参加美国退伍军人事务部（VA）百万退伍军人计划（MVP）的美国退伍军人进行的前瞻性队列研究。2023年至2024年对数据进行了分析。
LE8评分范围为0至100，分数越高表明心血管健康状况越好。
主要结局是无基线ASCVD的退伍军人的ASCVD总发病率，次要结局是基线时有或无ASCVD的退伍军人发生主要不良心血管事件（MACE）的发病率。
共纳入413052名退伍军人（平均[标准差]年龄，65.8[12.1]岁；378162[91.6%]为男性）。基于对279868名基线时无任何ASCVD的退伍军人进行的170万人年的随访，45067名退伍军人在随访期间发生了ASCVD事件。LE8总分及每个LE8因素分项评分均与ASCVD发病呈负向、线性、剂量反应关系。对于既往无ASCVD的退伍军人，LE8评分为80至100的人与LE8评分为0至49的人相比，ASCVD风险更低（调整后风险比[aHR]，0.36[95%CI，0.35 - 0.38]）。同样，无论基线ASCVD状态如何，LE8评分为80至100的退伍军人发生MACE的风险均显著低于基线时有ASCVD且LE8评分为0至49的退伍军人（有ASCVD：aHR，0.52[95%CI，0.48 - 0.56]；无ASCVD：aHR，0.14[95%CI，0.13 - 0.15]）。
在这项针对美国退伍军人的队列研究中，无论基线ASCVD状态如何，较高的LE8评分与显著较低的ASCVD发病风险及发生不良心血管事件的可能性降低相关。这些结果支持了LE8在健康促进和ASCVD预防方面的实用性。
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