Association between Life’s Essential 8 and all-cause or cardiovascular-specific mortality in patients with rheumatoid arthritis

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CER17322
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PMID: 38607691 [PubMed]

Received: 23/11/2023
Accepted : 29/01/2024
In Press: 05/04/2024

Abstract

OBJECTIVES:
Patients with rheumatoid arthritis (RA) have been found to have a higher cardiovascular disease (CVD) burden. We aimed to examine the associations between Life’s Essential 8 (LE8), a metric of cardiovascular health (CVH) recently proposed by the American Heart Association, and all-cause and CVD mortality in RA patients.
METHODS:
This prospective cohort study analysed RA patients from the National Health and Nutrition Examination Survey 2005–2018 with linked mortality data through December 31, 2019. Total LE8 scores were calculated and divided into the high- (LE8 80–100), moderate- (LE8 50–79), and low-CVH (LE8 0–49) groups. Weighted multivariable Cox regression, logistic regression and restricted cubic spline models were applied to explore the association between LE8 and outcomes.
RESULTS:
A total of 1424 RA patients were enrolled with a weighted mean age of 57.87 years and female proportion of 58.94%. During a median follow-up of 82 months, 270 all-cause (85 CVD) deaths were recorded. Compared with the high-CVH group, participants in the moderate- and low-CVH groups had an 85.8% and 129.5% increased risk of all-cause mortality, respectively. After adjustment for potential confounders, each 1 point decrease in LE8 score was associated with a 2.6% increased risk of CVD mortality. Subgroup analyses showed significant interactions between LE8 score and non-Hispanic white population with risk of all-cause mortality. The results were robust for all-cause mortality, but not for CVD mortality in the sensitivity analysis.
CONCLUSIONS:
CVH measured by the LE8 score is a robust and independent predictor of all-cause mortality among U.S. RA patients.

DOI: https://doi.org/10.55563/clinexprheumatol/ppsp71