生命关键的9个因素、遗传易感性与房颤风险：英国生物银行队列中的一项前瞻性研究

Life's Crucial 9, Genetic Susceptibility, and the Risk of Atrial Fibrillation: A Prospective Study in the UK Biobank Cohort.

作者信息

Li Jianing, Li Guoxian, Ma Ze, Sun Ziqing, Shi Yujie, Lou Zexin, Zhao Hanqing, Sun Mengtong, Wang Yu, Han Qiang, Jiang Miao, Shen Yueping

机构信息

Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, P.R. China; The Fourth Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China.

Department of Epidemiology and Biostatistics, School of Public Health, Medical College of Soochow University, Suzhou, P.R. China.

出版信息

Can J Cardiol. 2025 Jul 19. doi: 10.1016/j.cjca.2025.07.021.

DOI:10.1016/j.cjca.2025.07.021

PMID:40692006

Abstract

BACKGROUND

To date, the association between Life's Crucial 9 (LC9) and incidence of atrial fibrillation (AF) has not been explored. This study aimed to investigate the association between LC9 and the incidence of AF and evaluate the potential role of genetic risk.

METHODS

LC9 consists of 9 elements categorized as low, medium, and high cardiovascular health (CVH). Polygenic risk scores (PRSs) were categorized as low, medium, or high. A Cox proportional hazards regression model was used to determine the association between LC9 and incidence of AF. The combined effects and interactions between LC9 and AF PRS on incidence of AF were also examined.

RESULTS

During the median follow-up of 12.87 years, 11,141 patients developed AF. Moderate CVH (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.70, 0.79) and high CVH (HR, 0.66; 95% CI, 0.62, 0.71) were associated with a reduced risk of AF, respectively, compared with those with low CVH. Individuals with a high CVH and low PRS exhibited the lowest risk of AF compared with those with low CVH and high PRS (HR, 0.55; 95% CI, 0.47, 0.64). Additive interactions between low-to-moderate CVH and high PRS were found (relative excess risk caused by interaction: 95% CI, 1.45 [0.75, 2.15] and 0.60 [0.28, 0.92]; attributable proportion caused by interaction: 95% CI, 0.25 [0.15, 0.35] and 0.14 [0.06, 0.21], respectively).

CONCLUSIONS

Higher LC9 scores were associated with a decreased risk of AF. Adherence to the LC9 guidelines may help reduce the incidence of AF, regardless of genetic risk.

摘要

背景

迄今为止，尚未探讨生命关键9要素（LC9）与心房颤动（AF）发病率之间的关联。本研究旨在调查LC9与AF发病率之间的关联，并评估遗传风险的潜在作用。

方法

LC9由9个要素组成，分为低、中、高心血管健康（CVH）类别。多基因风险评分（PRS）分为低、中或高。采用Cox比例风险回归模型确定LC9与AF发病率之间的关联。还研究了LC9与AF PRS对AF发病率的联合效应和相互作用。

结果

在12.87年的中位随访期间，11141例患者发生了AF。与低CVH者相比，中度CVH（风险比[HR]，0.75；95%置信区间[CI]，0.70，0.79）和高度CVH（HR，0.66；95%CI，0.62，0.71）分别与AF风险降低相关。与低CVH和高PRS者相比，高CVH和低PRS的个体AF风险最低（HR，0.55；95%CI，0.47，0.64）。发现低至中度CVH与高PRS之间存在相加相互作用（交互作用引起的相对超额风险：95%CI，1.45[0.75，2.15]和0.60[0.28，0.92]；交互作用引起的归因比例：95%CI，分别为0.25[0.15，0.35]和0.14[0.06，0.21]）。