基于生命八要素的心血管健康评分与缺血性脑卒中预后相关性及临床检验指标的中介效应：一项多中心前瞻性队列研究

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Abstract：ObjectiveToinvestigatetheassociationbetweencardiovascularhealthscores（CVH）basedonLife'sEsential8 （LE8）and 90-day functional prognosis of patientswithacute ischemic stroke （AIS）and explore the mediating roleof laboratoryindicators toprovideevidenceforsecondarystrokeprevention.MethodsTismulticenter，prospectivecohortstudy wasconductedamong599AISpatientswithin 72h ofonset.Theclinical data ofthepatientswerecollected，and the cardiovascularhealth （CVH）scores werecalculatedacording toLE8criteria.Functional prognosis ofthe patientsat90days wereassessedbytelephonefollow-upusingthemodifiedRankinsalesoe（mRS），whosecorelationwiththetotalLE8sore and each individual item score were analyzed using multiple linear regression.Lasso regresionanalysis wasused to select laboratory markersassociated with 9-daymRS，andtheir mediatingrole intheLE8-outcomerelationship wereasessedusing theBootstrapmethod.ResultsAfteradjustingforconfounders，thetotalLE8scorewasfoundtoinverselycorrelatewith90- daymRS score of the patients（ 95% CI： -0.06--0.041; P<0.001 ）.Thescoresof7E8components （exercise，diet quality nicotineexporeepdseesolorrereelyedi （all P<0.05 ）.Amongthe laboratoryparameters，fibrinogen （FIB）waspositivelycorrelated 13=0.215， 95% CI： 0.068-0.361; P= 0.0041）whileMCHC β=-0.012 、 95% CI：-0.022--0.002;P=0.0229） and HRR（ β=-0.007 95% CI： -0.013-0.00; P=0.042） were negativelycorrelatedwith90-daymRSscores.FBsignificantlymediatedtherelationshipbetweenLE8scoresand90-daymR scoreswithan indirect effect of -0.0019 95% CI： -0.00381-0.00; P=0.006） and a mediation proportion of 3.778% 0 95% CI： 0.00869- 0.08）.ConclusionTheCVHscoresassessed byLE8are inverselycorelatedwith90-dayfunctionalprognosisof AIS patients， suggestingtheimportanceofmaintaining goodCVHfor improving stroke outcomes.FIB，MCHCand HRR levelsareinversely corelated with the patient prognosis，and FIB partially mediates the impactof LE8 scores onstroke outcomes. Keywords： Life's Essential 8; cardiovascular health score; acute ischemic stroke; prognosis; mediating effct

脑卒中作为致残率、致死率高的神经系统疾病，其预后受多重因素影响1。（剩余14442字）