Each 1-unit increase in the Life's Crucial 9 score was associated with a 1.9% decrease in all-cause mortality (HR 0.981; 95% CI 0.974-0.988) and outperformed LS7 and LE8 for risk prediction.
Cohort (n=7,247)
Does the Life's Crucial 9 score predict all-cause and cardiovascular mortality better than Life's Simple 7 and Life's Essential 8 in adults with arthritis?
The Life's Crucial 9 score is inversely associated with all-cause and cardiovascular mortality in patients with arthritis and offers superior prognostic value compared to older cardiovascular health metrics.
Estimación del efecto: HR 0.981 (95% CI 0.974-0.988)
OBJECTIVES Cardiovascular diseases (CVD) are the predominant cause of death in arthritis patients. For Life's Crucial 9 (LC9), a newly proposed cardiovascular health metric, its association with mortality in the arthritis population and its prognostic value compared to the conventional Life's Simple 7 (LS7) and Life's Essential 8 (LE8) remain unclear. STUDY DESIGN This is a prospective cohort study, data from seven cycles of the NHANES survey (2005-2018) were analyzed. METHODS In this prospective cohort study, participants with self-reported arthritis from the NHANES were followed-up until December 2019. Weighted Cox regression was used to analyze the association between LC9 and mortality, while predictive performance of each metric was compared using C-statistics and net reclassification improvement (NRI). RESULTS Among 7247 arthritis patients (weighted mean age 59.49 years, 59.86% female), 1293 deaths were recorded during a median follow-up of 6.58 years (32.17% were CVD-related). In fully adjusted models, each 1-unit increase in LC9 was linearly associated with a 1.9% decrease in all-cause mortality (hazard ratios HR = 0.981, 95% confidence intervals CI: 0.974-0.988) and 2.4% decrease in CVD mortality (HR = 0.976, 95% CI: 0.965-0.987). Weighted Quartile Sum identified physical activity (29.1%) and sleep health (32.2%) as the primary contributors to all-cause and cardiovascular mortality, respectively. Notably, LC9 consistently outperformed LS7 and LE8: for all-cause mortality, ΔC-statistic = +0.008 vs. LS7 and +0.002 vs. LE8, NRI was 6.6% and 2.1%, while for CVD mortality, ΔC-statistic = +0.013 vs. LS7 and +0.002 vs. LE8, NRI was 12.3% and 4.8%, respectively. CONCLUSIONS LC9 exhibits a linear inverse correlation with mortality in arthritis patients and demonstrates superior predictive performance compared to LS7 and LE8. This metric is useful for comprehensively evaluating mortality risk in arthritis patients.
Huang et al. (Mon,) conducted a cohort in arthritis (n=7,247). Life's Crucial 9 (LC9) score vs. Life's Simple 7 (LS7) and Life's Essential 8 (LE8) was evaluated on all-cause mortality (HR 0.981, 95% CI 0.974-0.988). Each 1-unit increase in the Life's Crucial 9 score was associated with a 1.9% decrease in all-cause mortality (HR 0.981; 95% CI 0.974-0.988) and outperformed LS7 and LE8 for risk prediction.