一项基于人群的队列研究:Life's Essential 8评分在心房颤动和心力衰竭发病率中中介社会经济地位的作用

IF 2.7 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Hellenic Journal of Cardiology Pub Date : 2024-12-30 DOI:10.1016/j.hjc.2024.12.006
Nana Wang, Xiaocan Jia, Zhixing Fan, Chaojun Yang, Yuping Wang, Jingwen Fan, Chenyu Zhao, Yongli Yang, Xuezhong Shi
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引用次数: 0

摘要

目的:探讨生活基本8 (Life’s Essential 8, LE8)评分是否介导社会经济地位(SES)与心房颤动(AF)和心力衰竭(HF)的关联。方法:来自UK Biobank的236,754名参与者被纳入研究。社会经济地位以家庭收入、受教育程度和就业状况为基础,采用潜在类别分析。在调整了年龄、性别、种族和酒精状况后,采用Cox回归来探讨SES与房颤和心衰的关系。采用反事实中介分析计算LE8得分的中介比例。根据年龄和性别进行分层分析。结果:在中位13.61年的随访中,记录了14635例房颤和6878例心衰。SES对AF总影响的HR (95% CI)为1.43(1.36,1.48)。LE8评分介导的间接效应为1.14(1.13,1.15),中介比例为40.84(36.97,47.01)%。SES对HF的总影响为2.44(2.26,2.59)。间接效应为1.28(1.25,1.29),中介比例为36.77(34.59,39.06)%。年龄< 60岁房颤的中介比例大于年龄≥60岁房颤的中介比例,男性房颤和HF的中介比例均高于女性。结论:房颤和心衰中大约三分之一的社会经济不平等可以用LE8评分来解释。这些发现强调了将心血管健康促进纳入旨在减轻社会经济健康不平等的公共卫生政策的重要性。
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Role of Life's Essential 8 score in mediating socioeconomic status in the incidence of atrial fibrillation and heart failure: a population-based cohort study.

Objective: To assess whether the Life's Essential 8 (LE8) score mediates the association of socioeconomic status (SES) with atrial fibrillation (AF) and heart failure (HF).

Methods: A total of 236,754 participants from the UK Biobank were included. SES was determined based on household income, education attainment, and employment status using latent class analysis. Cox regression was utilized to explore the association of SES with AF and HF after adjusting for age, sex, ethnicity, and alcohol status. Counterfactual mediation analysis was employed to calculate the mediation proportion of the LE8 score. Stratified analysis was conducted based on age and sex.

Results: With a median of 13.61 years of follow-up, 14,635 cases of AF and 6878 cases of HF were documented. The HR (95% CI) of the total effect of SES on AF was 1.43 (1.36, 1.48). The indirect effect mediated by the LE8 score was 1.14 (1.13, 1.15), with the mediation proportion being 40.84 (36.97, 47.01)%. The total effect of SES on HF was 2.44 (2.26, 2.59). The indirect effect was 1.28 (1.25, 1.29), with the mediation proportion being 36.77 (34.59, 39.06)%. The mediation proportion was greater for AF in age < 60 years compared to age ≥ 60 years, and it was also higher in males than females for both AF and HF.

Conclusion: Approximately one-third of the socioeconomic inequalities in AF and HF could be explained by the LE8 score. These findings highlighted the importance of integrating cardiovascular health promotion into public health policies aimed at mitigating socioeconomic health inequalities.

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来源期刊
Hellenic Journal of Cardiology
Hellenic Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
7.30%
发文量
86
审稿时长
56 days
期刊介绍: The Hellenic Journal of Cardiology (International Edition, ISSN 1109-9666) is the official journal of the Hellenic Society of Cardiology and aims to publish high-quality articles on all aspects of cardiovascular medicine. A primary goal is to publish in each issue a number of original articles related to clinical and basic research. Many of these will be accompanied by invited editorial comments. Hot topics, such as molecular cardiology, and innovative cardiac imaging and electrophysiological mapping techniques, will appear frequently in the journal in the form of invited expert articles or special reports. The Editorial Committee also attaches great importance to subjects related to continuing medical education, the implementation of guidelines and cost effectiveness in cardiology.
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