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  • Life’s Essential 8 and risks of mortality and cardiovascular morbidity in individuals with PRISm and its associations with transition trajectories of PRISm

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Respiratory epidemiology
Original research
Life’s Essential 8 and risks of mortality and cardiovascular morbidity in individuals with PRISm and its associations with transition trajectories of PRISm
  1. Yang Geng1,
  2. Yi Ding2,
  3. Xujia Lu1,
  4. Yalong Pei1,
  5. Matthew D Jankowich3,4,
  6. Chaofu Ke1
  1. 1 Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, China
  2. 2 Department of Preventive Medicine, College of Clinical Medicine, Suzhou Vocational Health College, Suzhou, Jiangsu, China
  3. 3 Providence VA Medical Center, Providence, Rhode Island, USA
  4. 4 Division of Pulmonary, Critical Care, and Sleep Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
  1. Correspondence to Chaofu Ke; cfke{at}suda.edu.cn

Abstract

Background Although morbidity and mortality are reportedly increased in individuals with preserved ratio impaired spirometry (PRISm), little is known about how to optimise PRISm-related health.

Aims Is Life’s Essential 8 (LE8) associated with mortality and cardiovascular morbidity in individuals with PRISm and with PRISm transition trajectories?

Methods Participants with PRISm (n=31 943) with complete data on LE8 and 23 179 individuals with two spirometry measurements were included from the UK Biobank. Eight health components were used to create the LE8 score (0–100). Cox proportional hazards models were used to assess associations of LE8 with cardiovascular morbidity and all-cause, cardiovascular and respiratory mortality. Multinomial logistic regression models were conducted to assess associations between LE8 and transition trajectories of PRISm.

Results Among participants with PRISm, 3113 (9.75%), 25 254 (79.06%) and 3576 (11.19%) were categorised as high (LE8≥80), moderate (50≤LE8<80) and low LE8 (LE8<50) score groups, respectively. Compared with the high LE8 group, the low LE8 group demonstrated higher risks of cardiovascular disease (HR: 2.702, 95% CI 2.391 to 3.054) and all-cause (2.496, 2.082 to 2.993), cardiovascular (4.165, 2.672 to 6.493) and respiratory mortality (4.103, 1.866 to 9.020). Individuals with low LE8 score (vs high LE8) had higher odds to transition from normal spirometry to PRISm (OR: 2.238, 95% CI 1.638 to 3.057) and lower odds to transition from PRISm to normal spirometry (OR: 0.506, 95% CI 0.339 to 0.757).

Conclusion A lower LE8 score was associated with increased risks of cardiovascular morbidity and all-cause, cardiovascular and respiratory mortality in PRISm. A lower LE8 score was related to higher likelihood of developing PRISm and lower likelihood of PRISm recovery.

  • Clinical Epidemiology
  • Pulmonary Disease, Chronic Obstructive

Data availability statement

Data may be obtained from a third party and are not publicly available. This research has been conducted using the UK Biobank Resource under Application Number 60651. The data that support the findings of this study are available on application to the UK Biobank team at http://www.ukbiobank.ac.uk/.

https://doi.org/10.1136/thorax-2024-222473

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. This research has been conducted using the UK Biobank Resource under Application Number 60651. The data that support the findings of this study are available on application to the UK Biobank team at http://www.ukbiobank.ac.uk/.

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    Footnotes

    • YG and YD contributed equally.

    • Contributors CK and MDJ designed the study. YG, YP and XL performed the data analysis. YG, YD, XL, CK and MDJ interpreted the results of statistical analysis. YG, YD, XL, CK and MDJ wrote the manuscript. All authors contributed to the interpretations of the findings. All authors reviewed the manuscript. CK is responsible for the overall content as the guarantor.

    • Funding This work was supported by the National Natural Science Foundation of China (81703316) and A Project Funded by Priority Academic Program Development of Jiangsu Higher Education Institutions (no award/grant number).

    • Disclaimer The views expressed by Dr. Jankowich are his own and do not necessarily represent the positions or policies of the Department of Veterans Affairs or the U.S. government.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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