Liu Yang, Zhao Maoxiang, Jiang Jinguo, Peng Xinyi, Luo Donglei, Chen Shuohua, Wu Shouling, Qin Xueying
Department of Epidemiology and Biostatistics, School of Public Health, Peking University, 38# Xueyuan Road, Haidian District, Beijing 100191, China.
Interventional Center of Valvular Heart Disease, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.
Eur J Prev Cardiol. 2025 Feb 5. doi: 10.1093/eurjpc/zwaf024.
The impact of Life's Essential 8 (LE8) on heart failure (HF) remains poorly understood. We examined the associations between three forms of LE8 measurements and HF.
A total of 35 896 participants without a prior history of HF from the Kailuan community were included. The LE8 status was measured in 2014. A latent mixture model was employed to identify the trajectories of LE8 during 2006 to 2014. The LE8 annual change rate was defined as the slope of the linear regression equation fitted by five LE8 measurements. Cox proportional hazards models were used to assess the risk of HF associated with LE8, after adjusting for potential confounding variables. The predictive performance was quantified and compared using the C-index. Five distinct LE8 trajectories were identified. 461 HF events documented during follow-up. The LE8 trajectories presenting an upward trend in LE8 were associated with a reduced risk of HF, even when the initial LE8 level was low [HR (95% confidence interval) for moderate-increasing vs. moderate-decreasing trajectory was 0.43 (0.34, 0.55)]. The LE8 status was inversely associated with HF risk. A higher LE8 annual increase was associated with a lower risk of HF. The LE8 trajectory was more accurate in predicting the risk of HF compared with LE8 status.
LE8 was inversely associated with HF risk. Individuals with initially low LE8 levels experienced a reversal in HF risk upon improvement. Both LE8 trajectories and status are practicable in identifying individuals at high risk of HF, LE8 trajectories may provide added prognostic information.
生命基本八项（LE8）对心力衰竭（HF）的影响仍知之甚少。我们研究了三种形式的LE8测量值与HF之间的关联。
共纳入开滦社区35896名无HF既往史的参与者。于2014年测量LE8状态。采用潜在混合模型确定2006年至2014年期间LE8的轨迹。LE8年变化率定义为通过五次LE8测量拟合的线性回归方程的斜率。在调整潜在混杂变量后，使用Cox比例风险模型评估与LE8相关的HF风险。使用C指数对预测性能进行量化和比较。确定了五条不同的LE8轨迹。随访期间记录到461例HF事件。即使初始LE8水平较低，呈现LE8上升趋势的LE8轨迹与HF风险降低相关[中度增加轨迹与中度降低轨迹的HR（95%置信区间）为0.43（0.34，0.55）]。LE8状态与HF风险呈负相关。较高的LE8年增长率与较低的HF风险相关。与LE8状态相比，LE8轨迹在预测HF风险方面更准确。
LE8与HF风险呈负相关。初始LE8水平较低的个体在改善后HF风险发生逆转。LE8轨迹和状态在识别HF高危个体方面均可行，LE8轨迹可能提供额外的预后信息。
