背景:据报道,在美国成年人中,基于较高的生命必需8(LE8)的心血管健康(CVH)与全因死亡率和心脑血管疾病(CCVD)相关死亡率的较低风险相关。同时,多项研究表明,CVH与卒中和CCVD风险显著负相关.由于没有研究调查LE8在中风患者中的适用性,本研究旨在探讨LE8与卒中患者全因死亡率和心脑血管死亡率的关系.
方法:在这项回顾性队列研究中,从2007-2018年的国家健康与营养调查(NHANES)数据库中提取患者数据。使用加权单变量和多变量COX回归分析来研究LE8与全因死亡率和心脑血管死亡率的关联。我们进一步探索了年龄亚组中的这些关系,性别,体重指数(BMI),癌症,充血性心力衰竭(CHF),冠心病(CHD)。评价指标为风险比(HRs)和95%置信区间(CIs)。
结果:在符合条件的患者中,278人死于全因,其中89人(8.38%)死于CCVD。在调整协变量后,LE8评分≥58.75的患者全因死亡率(HR=0.46,95CI:0.31-0.69)和心脑血管死亡率(HR=0.51,95CI:0.26-0.98)的风险较低,与LE8评分<48.123的人相比。在年龄<65岁的患者中,较高的LE8评分与较低的全因死亡风险相关。没有癌症,不管性别是什么,BMI,CHF或CHD条件(均P<0.05)。仅在年龄<65岁和非癌症亚组中发现高LE8评分与低心脑血管死亡风险之间存在相关性(均P<0.05)。
结论:较高的LE8评分与卒中患者全因死亡率和心脑血管死亡率的风险较低相关,为脑卒中的风险管理和预后改善提供一定的参考。然而,需要更多的证据来验证高LE8评分在卒中预后中的有益作用.
BACKGROUND: A higher Life\'s Essential 8 (LE8)-based cardiovascular health (CVH) has been reported to be associated with a lower risk of both all-cause mortality and cardio-cerebrovascular diseases (CCVDs) related mortality in adults in the United States. At the same time, multiple studies have shown a significant negative association of CVH with the risk of stroke and CCVDs. Since no research has investigated the applicability of the LE8 in stroke patients, this study aimed to explore the association of LE8 with all-cause mortality and cardio-cerebrovascular mortality in stroke patients.
METHODS: Data of patients were extracted from the National Health and Nutrition Examination Surveys (NHANES) database in 2007-2018 in this retrospective cohort study. Weighted univariate and multivariate COX regression analyses were utilized to investigate the associations of LE8 with all-cause mortality and cardio-cerebrovascular mortality. We further explored these relationships in subgroups of age, gender, body mass index (BMI), cancer, congestive heart failure (CHF), and coronary heart disease (CHD). The evaluation indexes were hazard ratios (HRs) and 95% confidence intervals (CIs).
RESULTS: Among the eligible patients, 278 died from all-cause and 89 (8.38%) of them died due to CCVDs. After adjusting for covariates, patients with LE8 score ≥ 58.75 seemed to have both lower risk of all-cause mortality (HR = 0.46, 95%CI: 0.31-0.69) and cardio-cerebrovascular mortality (HR = 0.51, 95%CI: 0.26-0.98), comparing to those with LE8 score < 48.123. Higher LE8 scores were associated with lower risk of all-cause mortality in patients aged < 65 years old, without cancer, and whatever the gender, BMI, CHF or CHD conditions (all P < 0.05). The relationships between high LE8 scores and low cardio-cerebrovascular mortality risk were only found in age < 65 years old and non-cancer subgroups (all P < 0.05).
CONCLUSIONS: A higher LE8 score was associated with lower risk of both all-cause mortality and cardio-cerebrovascular mortality in patients with stroke, which may provide some reference for risk management and prognosis improvement in stoke. However, more evidences are needed to verify this beneficial role of high LE8 score in stroke prognosis.