Abstract 4141021: Association of Cardiovascular Health by Life’s Essential 8 with Subsequent Coronary Artery Calcification: A Prospective Cohort Study

Introduction: “Life’s Essential 8” (LE8) is an updated construct for measuring cardiovascular health (CVH). We hypothesized that a higher CVH score by LE8 is associated with a lower risk of subsequent coronary artery calcification (CAC>0) among middle-aged Koreans. Methods: The Cardiovascular and Metabolic Diseases Etiology Research Center (CMERC) study is a community-based prospective cohort study conducted in Seoul, Korea, including 1,269 healthy participants with a baseline visit in 2013-2018 and a follow-up visit in 2022-2023. The baseline CVH score was calculated as the average of 8 metrics: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure, each scaled from 0 to 100 points, according to the AHA’s LE8 definition. The CVH scores of 80 to 100 were classified as “high”, 50 to <80 as “moderate”, and 0 to <50 as “low” CVH group. The main outcome was CAC>0 at the follow-up visit. The association of baseline CVH score with the outcome was evaluated based on odds ratios (OR) and 95% confidence intervals (CI) using multivariable logistic regression models. Results: At baseline, the median age of the participants was 55 years, and 65.5% were female. After a median follow-up of 7 years, 519 (40.9%) participants had CAC>0. The proportion of CAC>0 at follow-up was 65.3% in the low CVH group, 40.6% in the moderate CVH group, and 31.0% in the high CVH group (Figure A). Using the low CVH group as the reference, the multivariable-adjusted OR (95% CI) for follow-up CAC>0 was 0.37 (0.25-0.55) in the moderate CVH group and 0.24 (0.15-0.38) in the high CVH group. Higher baseline CVH scores were log-linearly associated with lower odds of follow-up CAC>0 (Figure B). Each 10-point higher baseline CVH score was associated with a 27% lower odds of CAC>0 at follow-up (OR, 0.73; 95% CI, 0.66-0.82). The association was consistent across pre-specified subgroups and sensitivity analyses. Conclusions: Higher CVH by LE8 score was associated with a lower risk of developing CAC>0 among healthy middle-aged Koreans, suggesting the importance of promoting ideal CVH for the prevention of cardiovascular disease.