American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study.
American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study.
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DOI：
10.1161/jaha.117.008424
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发表时间：
2018-04-12
影响因子：
5.4
通讯作者：
Alonso A
中科院分区：
文献类型：
--
作者：
Garg PK;O'Neal WT;Chen LY;Loehr LR;Sotoodehnia N;Soliman EZ;Alonso A
美国心脏协会定义了理想心血管健康的指标，称为生活简单7(LS7)，以预防心血管疾病。我们在一组没有已知心血管疾病的中老年人的双相队列中研究了LS7与房颤(AF)的相关性。这项分析包括13-182名ARIC(社区动脉粥样硬化风险)研究参与者(平均基线年龄=54±5.7岁；56%女性；25%黑人)，没有房颤和心血管疾病。LS7总分是LS7各部分得分的总和，分为心血管健康不佳(0-4分)、一般(5-9分)或最佳(10-14分)。主要结果是房颤事件，主要通过截至2014年12月31日的房颤的心电图和出院编码来确定。在25.1年的中位数随访中，总共发现了2266例(17%)房颤事件。与不足类别(n=1057)相比，在多变量Cox比例风险模型中，平均类别(n=8629)和最佳类别(n=3496)的参与者发生房颤的风险较低(平均风险比0.59，95%可信区间0.51，0.67；风险比0.38，95%可信区间0.32，最佳风险比0.44)。在类似的模型中，LS7得分高1分与发生房颤的风险降低12%相关(危险比0.88，95%可信区间0.86，0.89)。在没有基线心血管疾病的个体中，较高的LS7评分与较低的房颤风险密切相关。确定是否需要改善人群心血管健康的干预措施也能降低房颤的发生率。
The American Heart Association has defined metrics of ideal cardiovascular health known as Life's Simple 7 (LS7) to prevent cardiovascular disease. We examined the association between LS7 and incident atrial fibrillation (AF) in a biracial cohort of middle‐ and older‐aged adults without known cardiovascular disease. This analysis included 13 182 ARIC (Atherosclerosis Risk in Communities) study participants (mean baseline age=54±5.7 years; 56% women; 25% black) free of AF and cardiovascular disease. An overall LS7 score was calculated as the sum of the LS7 component scores and classified as inadequate (0‐4), average (5‐9), or optimal (10‐14) cardiovascular health. The primary outcome was incident AF, identified primarily by ECG and hospital discharge coding of AF through December 31, 2014. A total of 2266 (17%) incident AF cases were detected over a median follow‐up of 25.1 years. Compared with the inadequate category (n=1057), participants in the average (n=8629) and optimal (n=3496) categories each had a lower risk of developing AF in a multivariable Cox proportional hazards model (hazard ratio 0.59, 95% confidence interval 0.51, 0.67 for average; and hazard ratio 0.38, 95% confidence interval 0.32, 0.44 for optimal). In a similar model, a 1‐point‐higher LS7 score was associated with a 12% lower risk of incident AF (hazard ratio 0.88, 95% confidence interval 0.86, 0.89). A higher LS7 score is strongly associated with a lower risk of AF in individuals without baseline cardiovascular disease. Determining whether interventions that improve the population's cardiovascular health also reduce AF incidence is needed.