Chen Haozhang, Li Ruyi, Liu Sen, Zhao Shiyu, Guo Tianyu, Tian Shufan, Zhong Jiale, Tang Zijun, Ge Zhenghao, Xia Jiawei, Geng Tingting, Pan Xiongfei, Pan An, Qian Frank, Liu Gang
Department of Nutrition and Food Hygiene, Hubei Key Laboratory of Food Nutrition and Safety, Ministry of Education Key Lab of Environment and Health, and State Key Laboratory of Environment Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Section of Epidemiology and Population Health & Department of Obstetrics and Gynecology, Ministry of Education Key Laboratory of Birth Defects and Related Diseases of Women and Children & National Medical Products Administration Key Laboratory for Technical Research on Drug Products In Vitro and In Vivo Correlation, West China Second University Hospital, Sichuan University, Chengdu, China.
Eur J Prev Cardiol. 2025 Jan 31. doi: 10.1093/eurjpc/zwaf021.
To assess whether better cardiovascular health is associated with a lower long-term risk of CVD in women with a history of adverse pregnancy outcomes (APOs).
Using data from the UK Biobank prospective cohort, we included 2,263 participants with prior APOs and 107,260 participants without prior APOs. Life's Essential 8 (LE8) score was assessed at baseline. Multivariable-adjusted Cox models were used to estimate the associations between LE8 score and CVD events.
Over a median 13.5 years of follow-up, 11,134 incident CVD events were documented. Among women with prior APOs, the incidence of total CVD was significantly lower in the top tertile compared to the bottom tertile, with a HR (95% CI) of 0.43 (0.29, 0.65). A similar trend was observed in women without APOs, with an HR (95% CI) of 0.55 (0.53, 0.58). With respect to the individual CVD outcomes, among women with APOs, only the associations with coronary heart disease, HR (95% CI) for T3 vs T1: 0.30 (0.17, 0.55) and atrial fibrillation, 0.47 (0.24, 0.91), achieved statistical significance. Women with high LE8 score and prior APOs had a similar long-term cardiovascular risk compared to women with high LE8 score and no prior APOs, 0.95 (0.63, 1.44).
Among women with a history of APOs, better cardiovascular health as assessed using LE8 was associated with a significantly lower incidence of CVD, particularly coronary heart disease and atrial fibrillation. The excess risk associated with APOs appears to be attenuated among those with a high LE8 score.
评估在有不良妊娠结局（APO）病史的女性中，更好的心血管健康状况是否与较低的心血管疾病（CVD）长期风险相关。
利用英国生物银行前瞻性队列的数据，我们纳入了2263名有既往APO病史的参与者和107260名无既往APO病史的参与者。在基线时评估生命必需的8项（LE8）评分。使用多变量调整的Cox模型来估计LE8评分与CVD事件之间的关联。
在中位13.5年的随访期内，记录了11134例新发CVD事件。在有既往APO病史的女性中，与最低三分位数相比，最高三分位数的总CVD发病率显著更低，风险比（HR）（95%置信区间）为0.43（0.29，0.65）。在无APO病史的女性中观察到类似趋势，HR（95%置信区间）为0.55（0.53，0.58）。关于个体CVD结局，在有APO病史的女性中，仅与冠心病的关联，T3与T1的HR（95%置信区间）为0.30（0.17，0.55）以及与心房颤动的关联，HR为0.47（0.24，0.91），达到统计学显著性。与无既往APO病史且LE8评分高的女性相比，有既往APO病史且LE8评分高的女性具有相似的长期心血管风险，HR为0.95（0.63，1.44）。
在有APO病史的女性中，使用LE8评估的更好的心血管健康状况与显著更低的CVD发病率相关，尤其是冠心病和心房颤动。在LE8评分高的人群中，与APO相关的额外风险似乎有所减弱。
