Abstract 4144944: Critical Insights for a High-Risk Population: Low Life’s Essential 8 Scores among Post-Operative Coronary Artery Bypass and Percutaneous Coronary Intervention Patients; All of Us Research Program

Background: The American Heart Association’s (AHA) Life’s Essential 8 (LE8) concept serves as a quantitative framework for assessing cardiovascular health (CVH). Post-operative coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) patients are at high-risk for subsequent cardiovascular events (CVE). However, LE8 scores for post-procedural CABG or PCI patients remain unknown. Methods: Isolated post-operative CABG (n=208) or PCI (n=739) non-institutionalized patients from the National Institutes of Health’s (NIH) All of Us (AoU) Research Program (2017-2022) were included. LE8 scores (range 0-100, higher = better CVH; excluding diet metric) were calculated using methods recommended by the AHA. Physical activity and sleep metrics were derived from patients' Fitbit data, while all other metrics were sourced from electronic health records (EHR). Results: Overall LE8 scores for post-operative CABG (57.9 [95% CI: 56.6-59.2]) and PCI patients (55.3 [54.4-56.1]) were significantly lower than that of the general population (65.9 [65.1-66.7] (p<0.001). Significantly lower LE8 metrics were observed in post-op CABG and PCI patients compared to the general population for the following factors: nicotine exposure (-4.1 vs. -8.3, respectively), sleep health (-19.5 vs. -23.6), body mass index (-9.4 vs. -10.8), blood glucose (-36.5 vs. -35.0), and blood pressure (-13.5 vs. -16.5). Physical activity scores were low for post-op CABG patients (56.6 [52.3-60.8]), PCI patients (54.7 [52.3-57.1]), and the general population (51.6 [53.5-59.7]) (Figure 1A, 1B). Conclusion: Our study indicates that post-op CABG and PCI patients, who are at significantly increased risk for subsequent CVE, exhibit critically low overall CVH as measured by AHA’s LE8 metrics. These findings highlight the urgent need for targeted interventions, with nicotine exposure, physical activity, BMI, blood glucose, and blood pressure identified as key areas for improvement. Since LE8 metrics include behavioral and physiologic metrics associated with CVD risk, further research should focus on effective strategies to address these deficits in post-operative PCI and CABG patients.