基于生命八要素的心血管健康评分与新发心房颤动的关联研究

Background?The prevalence of atrial fibrillationAFhas continued to rise globally in recent yearsand AF increases the risk of strokeheart failuremyocardial infarctionchronic kidney diseaseand other diseases. Studies have identified hypertensiondiabetessmokingobstructive sleep apneaobesity and sedentary lifestyle as risk factors for AF. And most of these factors are within the scope of the "Life's Essential 8"LE8proposed by the American Heart Association. Objective?To investigate the relationship between cardiovascular healthCVHscore based on the LE8 and AF. Methods?A prospective cohort study was conducted in which 91 131 employees of Kailuan Group in TangshanHebei Province were selected for physical examination from June 2006 to October 2007and the LE8 score was evaluated according to the algorithm developed by the American Heart Associationand combined with the actual situation of the Kailuan study to form the Kailuan study version of LE8including 4 health behaviorsdietphysical activitytobacco exposureand sleepand 4 health factorsBMIblood lipidsblood glucoseand blood pressure. The study subjects were divided into the three groups of the low CVH groupn=8 407with a LE8 score less than 50the medium CVH groupn=73 493with a LE8 score of 50 or more but less than 80and the high CVH groupn=9 231with a LE8 score of 80 or more. The follow-up visit was performed per year with the time of the study subject's first Kailuan physical examination as the starting pointthe occurrence of AF as the endpoint eventthe end of AF and follow-up2020-12-31as the endpoint time. Kaplan Meier survival curve was used to analyze the cumulative incidence of new-onset AF in different groupsand log rank test was used to compare the differences between groupsCox proportional hazards regression analysis was used to investigate the impact of different LE8 score groups and single factor scores on the risk of new-onset AF. Results?There were significant differences in agegendereducation levelfamily incomehistory of alcohol consumptionand LE8 scores among the three groups of subjectsP<0.001. During follow-up1088 cases of new-onset AF were identifiedincluding 133 cases1.58%in the low CVH group882 cases1.20%in the medium CVH groupand 72 cases0.78%in the high CVH group. The median follow-up time was 15.014.715.2yearsthere was statistically significant difference in the comparison of cumulative incidence rate of new-onset AF in the three groups P<0.001. Cox proportional hazards regression analysis after adjusting for agegendereducation levelhousehold incomeand history of alcohol consumption showed thatcompared with the low CVH groupboth the medium CVH groupHR=0.69795%CI=0.579-0.841P<0.001and the high CVH groupHR=0.60995%CI=0.454-0.816P=0.001reduced the risk of new-onset AF. An increase in LE8 score could reduce the risk of new-onset AFHR=0.85995%CI=0.804-0.918P<0.001. The individual factors of LE8including BMI scoreHR=0.76295%CI=0.717-0.809P<0.001and blood pressure scoreHR=0.82495%CI=0.776-0.876P<0.001were negatively correlated with the risk of new-onset AF. Conclusion?The LE8 score of CVH is negatively correlated with the risk of new-onset AFand the individual factors of LE8including BMI score and blood pressure scoreare negatively correlated with the risk of new-onset AF.