Gong Hongyang, Gao Ming, Zeng Zhiwen
Department of Physiology, College of Medicine, Chosun University, Gwangju, Republic of Korea.
Department of Gastroenterology, The First Hospital of Jilin University, Changchun, Jilin, China.
BMC Cancer. 2025 Apr 30;25(1):805. doi: 10.1186/s12885-025-14229-2.
Life's Crucial 9 (LC9) is a recently proposed cardiovascular health (CVH) scoring system that integrates psychological well-being with Life's Essential 8 (LE8). However, its prognostic value remains unclear. This study aims to investigate the association between LC9 and outcomes among cancer survivors.
A total of 2,558 cancer survivors from the National Health and Nutrition Examination Survey (NHANES) 2005-2018 were included in this study. LC9, representing a dimension of psychological health, was calculated as the average of the LE8 score and the depression score. Cox proportional hazards regression, restricted cubic spline (RCS) analysis, subgroup analysis, and Kaplan-Meier survival curves were employed to evaluate the association between LC9 and mortality risk, with adjustments for potential confounders.
During an average follow-up period of 80 months, 640 deaths occurred, including 205 from cancer and 128 from cardiovascular disease. After adjusting for all covariates using Cox regression, a 10-point increase in the LC9 score was associated with a 24% reduction in all-cause mortality (HR: 0.76; 95% CI: 0.68-0.84), a 19% reduction in cancer-specific mortality (HR: 0.81; 95% CI: 0.68-0.97), and a 28% reduction in cardiovascular mortality (HR: 0.72; 95% CI: 0.58-0.90). Kaplan-Meier survival curves indicated lower rates of all-cause, cancer-specific, and cardiovascular mortality among participants with higher LC9 scores. RCS analysis revealed a linear inverse association between LC9 and all-cause and cancer-specific mortality and a nonlinear inverse association with cardiovascular mortality.
Among cancer survivors in the United States, higher LC9 scores were independently associated with lower risks of all-cause, cancer-specific, and cardiovascular mortality. This finding highlights the potential link between cardiovascular health and survival outcomes in cancer survivors, suggesting that improving cardiovascular health may serve as an important preventive strategy to enhance survival rates in this population.
生命关键9分（LC9）是最近提出的一种心血管健康（CVH）评分系统，它将心理健康与生命基本8分（LE8）相结合。然而，其预后价值仍不明确。本研究旨在调查LC9与癌症幸存者结局之间的关联。
本研究纳入了2005 - 2018年美国国家健康与营养检查调查（NHANES）中的2558名癌症幸存者。LC9代表心理健康维度，计算方法为LE8得分与抑郁得分的平均值。采用Cox比例风险回归、限制性立方样条（RCS）分析、亚组分析和Kaplan-Meier生存曲线来评估LC9与死亡风险之间的关联，并对潜在混杂因素进行了调整。
在平均80个月的随访期内，发生了640例死亡，其中205例死于癌症，128例死于心血管疾病。使用Cox回归对所有协变量进行调整后，LC9得分每增加10分，全因死亡率降低24%（风险比：0.76；95%置信区间：0.68 - 0.84），癌症特异性死亡率降低19%（风险比：0.81；95%置信区间：0.68 - 0.97），心血管死亡率降低28%（风险比：0.72；95%置信区间：0.58 - 0.90）。Kaplan-Meier生存曲线表明，LC9得分较高的参与者全因、癌症特异性和心血管死亡率较低。RCS分析显示，LC9与全因和癌症特异性死亡率之间呈线性负相关，与心血管死亡率呈非线性负相关。
在美国的癌症幸存者中，较高的LC9得分与较低的全因、癌症特异性和心血管死亡率风险独立相关。这一发现突出了心血管健康与癌症幸存者生存结局之间的潜在联系，表明改善心血管健康可能是提高该人群生存率的重要预防策略。
