Abstract
Objective Whether optimal cardiovascular health metrics may reduce the risk of cardiovascular events in secondary prevention is uncertain. The study was conducted to evaluate the influence of lifestyle changes on clinical outcomes among the subjects underwent percutaneous coronary intervention (PCI). Methods The study group consists of 17,099 consecutive PCI patients. We recorded data on subject lifestyle behavior changes after their procedure. Patients were categorized as ideal, intermediate, or poor CV health according to a modified Life's Simple 7 score (on body mass, smoking, physical activity, diet, cholesterol, blood pressure, and glucose). Multivariable COX regression was used to evaluate the association between CV health and revascularization event. We also tested the impact of cumulative cardiovascular health score on reoccurrence of cardiovascular event. Results During a 3-year median follow-up, 1,583 revascularization events were identified. The observed revascularization rate was 8.0%, 9.3%, and 10.6% in the group of patients with optimal (a modified Life's Simple 7 score of 11–14), average (score = 9 or 10), or inadequate (less or equal than 8) CV health, respectively. After multivariable analysis, the adjusted hazard ratios were 0.83 (95% CI: 0.73–0.94) and 0.89 (95% CI: 0.79–0.99) for patients with optimal and average lifestyle changes comparing with the inadequate tertile (P for trend = 0.003). In addition, each unit increase in above metrics was associated with a decrease risk of revascularization (HR, 0.96; 95% confidence interval, 0.93–0.98; P for trend = 0.003). In addition, each unit increase in above metrics was associated with a decrease risk of revascularization (HR, 0.96; 95% confidence interval, 0.93–0.98; Conclusion Ideal CV health related to lower incidence of cardiovascular events, even after the percutaneous coronary intervention. Revascularization can be reduced by lifestyle changes. The cardiovascular health metrics could be extrapolated to secondary prevention and need for further validation.
Highlights
Ideal cardiovascular health (CVH) has been proposed by the American Heart Association (AHA) and used to measure population health [1]. e seven risk factors (Life’s Simple 7) that people can improve through lifestyle changes included four health behaviors and three health factors
Cumulative evidence already demonstrated the AHA ideal CVH metrics could be used for cardiovascular health factors assessment, health promotion, and a tool to predict mortality and cardiovascular diseases (CVD) risk [2, 3]. e steep gradient relationship between ideal CVH metrics and CVD was similar across different regions and diverse race-ethnic groups [4,5,6,7,8]
Erefore, our aim in this study is to investigate the influence of ideal CVH as a risk factor of cardiovascular outcomes for secondary prevention. e study was based on a cohort of patients who underwent percutaneous coronary intervention
Summary
Ideal cardiovascular health (CVH) has been proposed by the American Heart Association (AHA) and used to measure population health [1]. e seven risk factors (Life’s Simple 7) that people can improve through lifestyle changes included four health behaviors (stop smoking, eat better, get active, and lose weight) and three health factors (manage blood pressure, control cholesterol, and reduce blood sugar). Ideal cardiovascular health (CVH) has been proposed by the American Heart Association (AHA) and used to measure population health [1]. Cumulative evidence already demonstrated the AHA ideal CVH metrics could be used for cardiovascular health factors assessment, health promotion, and a tool to predict mortality and cardiovascular diseases (CVD) risk [2, 3]. It should be noticed that most of the individual components in ideal CVH metrics associated with reduced clinical event risk for the subject with established CVD [18, 19]. Few data are available on the relationship between having ideal risk factor profile using a composite measure and the recurrence of cardiovascular events. Erefore, our aim in this study is to investigate the influence of ideal CVH as a risk factor of cardiovascular outcomes for secondary prevention. We hypothesized that the subjects with optimal CVH would be less likely to develop cardiovascular events during their follow-up period
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