Abstract P3133: Cardiovascular Health Levels and Incident Cardiovascular Event Risk in Individuals with Autoimmune Diseases

Introduction: Established evidence has shown individuals with autoimmune diseases (ADs) have a higher risk of cardiovascular disease (CVD) compared to those without ADs. Hypothesis: We aimed to assess whether a high level of cardiovascular health (CVH) could mitigate this excess risk among individuals with ADs. Methods: A total of 13,229 participants diagnosed with any of 19 common ADs and free of CVD at baseline were included and matched with 46,609 controls without ADs based on age, sex, and assessment center in the UK biobank. The CVH levels (low, moderate, high) were estimated using the American Heart Association Life's Essential 8 score. Cox proportional hazards models were used to assess associations of levels of CVH with the risk of incident CVD events. Results: Over a median follow-up of 13.3 years, 3,752 (28.4%) CVD incidence occurred among participants with ADs (incidence rate: 25.23 per 1,000 person-years vs. 15.39 in matched controls; hazard ratio [HR] 1.57 [95% CI 1.51-1.63]). Compared to low CVH, a high CVH level was associated with a 44% lower risk of incident CVD in participants with ADs (HR 0.56 [95% CI 0.49-0.64]). Compared with participants without ADs, the excess CVD risk decreased substantially from 127% (HR 2.27 [95% CI 2.08-2.48]) in participants with ADs and low CVH to 31% (HR 1.31 [95% CI 1.18-1.46]) in the with ADs and high CVH. Conclusions: Higher CVH, defined by Life's Essential 8 score was significantly associated with lower CVD risk in participants with ADs, but even an optimal CVH managed in participants with ADs still has an excess CVD risk when compared with participants without ADs.