Toro Camilo, Daniels Ayelet Shapira, Prescott Brenton, Xanthakis Vanessa, Nayor Matthew, Gajjar Priya, Benjamin Emelia J, Preis Sarah R
Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Section of Cardiovascular Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine, Boston, MA, USA.
Am J Prev Cardiol. 2025 May 31;23:101018. doi: 10.1016/j.ajpc.2025.101018. eCollection 2025 Sep.
Atrial fibrillation (AF) burden can be reduced by targeting modifiable risk factors. Limited data exist on the association between American Heart Association's Life's Essential 8 (LE8) score (higher scores healthier) and AF incidence.
We studied AF-free Framingham Heart Study Offspring and Omni 1 participants aged ≥45 years who attended ≥1 index exam in which LE8 components were assessed. LE8 scores were calculated incorporating body mass index, blood pressure, non-HDL cholesterol, glucose, smoking, physical activity, diet, and sleep. Fine-Gray hazards models, accounting for the competing risk of death, were used to calculate subdistribution hazards ratios (sHR) for the association of LE8 score and its components with 10-year AF incidence.
We included 3161 unique participants ( = 4628 index exams, 57 % women, mean age 65±9 years). Participants were classified as having "ideal" (LE8≥80; 16 % [ = 763 exam cycles]), "intermediate" (LE8 50-79; 76 % [ = 3519]), or "poor"(LE8<50; 7 % [ = 346]) cardiovascular health. There were 410 incident AF events (10.4/1000 person-years). Compared with "ideal", a "poor" LE8 score was associated with higher AF risk (sHR,1.78; 95 %CI, 1.20-2.64; = 0.004); we did not observe a statistically significant association comparing participants with "intermediate" LE8 scores to those with "low" LE8 scores with regards to AF risk. Higher LE8 scores (healthier; continuous) were associated with lower AF risk (sHR per 1-SD increase increment of LE8 score, 0.80; 95 %CI, 0.72-0.90; < 0.0001).
Lower LE8 scores were associated with greater risk of developing AF. Future studies of the role of LE8 in reducing AF burden in the overall population are warranted.
通过针对可改变的风险因素，可以降低房颤（AF）负担。关于美国心脏协会的生命基本8要素（LE8）评分（分数越高越健康）与房颤发病率之间的关联，现有数据有限。
我们研究了弗雷明汉心脏研究后代队列和Omni 1队列中年龄≥45岁且参加过≥1次评估LE8各要素的索引检查的无房颤参与者。LE8评分的计算纳入了体重指数、血压、非高密度脂蛋白胆固醇、血糖、吸烟、体育活动、饮食和睡眠等因素。使用考虑死亡竞争风险的Fine-Gray风险模型来计算LE8评分及其各要素与10年房颤发病率关联的亚分布风险比（sHR）。
我们纳入了3161名独特的参与者（共4628次索引检查，57%为女性，平均年龄65±9岁）。参与者被分类为具有“理想”（LE8≥80；16%[共763个检查周期]）、“中等”（LE8 50-79；76%[共3519个]）或“较差”（LE8<50；7%[共346个]）心血管健康状况。共有410例房颤事件（1o.4/1000人年）。与“理想”情况相比，“较差”的LE8评分与更高的房颤风险相关（sHR，1.78；95%CI，1.20-2.64；P=0.004）；在房颤风险方面，我们未观察到“中等”LE8评分的参与者与“较差”LE8评分的参与者之间存在统计学上的显著关联。更高的LE8评分（更健康；连续变量）与更低的房颤风险相关（LE8评分每增加1个标准差的sHR为0.80；95%CI，0.72-0.90；P<0.0001）。
较低的LE8评分与发生房颤的更大风险相关。有必要对LE8在降低总体人群房颤负担中的作用进行进一步研究。
