Association of Life's Essential 8 Scores with Carotid Artery Plaque in Chinese Adults: A Prospective Cohort Study

The American Heart Association (AHA) proposed Life's Essential 8 score (LE8) in 2022 as a new metric for cardiovascular health (CVH). This study investigated the association between the LE8 score and the development of carotid artery plaque.

Data were drawn from the Asymptomatic Polyvascular Abnormalities Community (APAC) cohort study. In 2010, 1,938 participants without carotid plaques were recruited and followed-up until 2012. LE8 scores ranging from 0 to 100 were categorized as low (0-49), moderate (50-79), and high (80-100), whereas carotid plaques were measured using color Doppler ultrasound. A logistic analysis was used to analyze the association between the LE8 score and carotid plaque.

During the 2-year follow up period, 350 (18.1%) patients developed new carotid plaques. The incidence of newly developed carotid plaques decreased from 27.0% in the low-LE8 group to 13.7% in the high-LE8 group (p＜0.001). Adjusted odds ratios (ORs) for plaque development were 0.65 (95% confidence interval [CI], 0.45-0.93) in the moderate-LE8 group and 0.55 (95% CI, 0.34-0.90) in the high-LE8 group compared to the low-LE8 group. Higher LE8 scores were associated with a lower risk of stable and multiple carotid plaques.

An elevated LE8 score was associated with a lower risk of carotid plaque formation as well as plaque stability and quantity. Promoting adherence to optimal CVH levels may be beneficial in reducing the burden of carotid plaques and the risk of cardiovascular disease.