The association between time-weighted cumulative life's essential 8 and aortic valve calcification

Figures

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  Figure 1. Flowchart of participant selection. The flowchart illustrates the process of participant inclusion and exclusion in the present study. A total of 50,016 participants who completed health examinations in the Kailuan Study between 2006 and 2012 were initially identified. Among them, 15,742 participants underwent echocardiographic examination after the 2012 health examination. We excluded 168 participants with prevalent aortic valve calcification before 2012 and 253 participants with missing LE8 data in any health examination record between 2006 and 2012. Finally, 15,321 participants were included in the analysis.

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  Figure 2. Forest plot of sensitivity analyses for the association between time-weighted cumulative Life's Essential 8 (TWC-LE8) and aortic valve calcification (AVC). The figure displays odds ratios (95% confidence intervals) derived from multiple sensitivity analyses. The number of cases, total participants, and AVC prevalence (%) are presented for each subgroup. Note: Models were adjusted for age, sex, alcohol consumption history, education level, average income, occupation, family history of myocardial infarction, family history of stroke, eGFR and hs-CRP. Abbreviations: eGFR, estimated glomerular filtration rate; hs-CRP, high-sensitivity C-reactive protein; CVH, cardiovascular health; AVC, aortic valve calcification.

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  Figure 3. Association between cardiovascular health (CVH) and aortic valve calcification (AVC) stratified by sex and age. Forest plots show the odds ratios (95% confidence intervals) for the association between CVH levels and AVC in subgroups defined by sex and age. Note: Models were adjusted for age, sex, alcohol consumption history, education level, average income, occupation, family history of myocardial infarction, family history of stroke, eGFR and hs-CRP. Abbreviations: eGFR, estimated glomerular filtration rate; hs-CRP; CVH, cardiovascular health; AVC, aortic valve calcification.

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  Figure 4. Logistic regression analysis of the association between cardiovascular health (CVH) and aortic valve calcification (AVC) after excluding individual LE8 components one by one. Forest plots present odds ratios (95% confidence intervals) based on time-weighted cumulative mean CVH scores derived from the remaining seven components. Note: To analyze the dose–response relationship between TWC-LE8 scores and AVC, we selected nodes at the 10th, 50th, and 90th percentiles of the TWC-LE8 score. Multivariable regression models were employed, adjusting for potential confounders, including age, sex, alcohol consumption history, education level, average income, occupation, family history of myocardial infarction, family history of stroke, eGFR and hs-CRP. Abbreviations: eGFR, estimated glomerular filtration rate; hs-CRP; TWC-LE8, time-weighted cumulative life's essential 8 scores; AVC, aortic valve calcification.

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  Figure 5. Restricted cubic spline analysis of the association between time-weighted cumulative Life's Essential 8 (TWC-LE8) scores and aortic valve calcification (AVC). The restricted cubic spline plot illustrates the dose–response relationship between TWC-LE8 scores and the risk of AVC. Knots were placed at the 10th, 50th, and 90th percentiles of the TWC-LE8 score distribution. Multivariable logistic regression models were used with adjustment for age, sex, alcohol consumption, education level, average income, occupation, family history of myocardial infarction, family history of stroke, estimated glomerular filtration rate (eGFR), and high-sensitivity C-reactive protein (hs-CRP). The solid red line represents the estimated odds ratio, and the dashed lines indicate the 95% confidence intervals.