{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T02:05:21Z","timestamp":1791943521416,"version":"4.3.4"},"reference-count":12,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":14,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Coronary heart disease (CHD) confers a substantial global burden, and comprehensive health assessment is critical for secondary prevention. However, the independent and joint associations of multidimensional health with long\u2010term mortality in CHD patients remain unclear in population\u2010based studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective cohort study included 4823 U.S. adults with self\u2010reported CHD using linked data from the National Health and Nutrition Examination Survey 1999\u20132018 and National Center for Health Statistics mortality files (through 2019). Associations were evaluated using Cox proportional hazards and Fine\u2013Gray competing risk models, with hazard ratios (HRs) and 95% confidence intervals (CIs) estimated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow\u2010up of 6.2 years (IQR: 3.5\u20139.1), 1542 deaths occurred, including 587 cardiac deaths. After full adjustment, compared with low Comprehensive Health Assessment Score (CHAS [reference]), moderate CHAS was associated with lower all\u2010cause mortality (HR\u2009=\u20090.68; 95% CI: 0.59\u20130.78) and cardiac mortality (HR\u2009=\u20090.62; 95% CI: 0.51\u20130.76); High CHAS showed further risk reductions (all\u2010cause mortality: HR\u2009=\u20090.45; 95% CI: 0.38\u20130.53; cardiac mortality: HR\u2009=\u20090.39; 95% CI: 0.30\u20130.51). Dose\u2013response relationships were observed (P for trend &lt;\u20090.001). Physical activity (\u2265\u2009150 MET\u2010min\/week) (all\u2010cause mortality: HR\u2009=\u20090.71; 95% CI: 0.63\u20130.80) and statin use (cardiac mortality: HR\u2009=\u20090.58; 95% CI: 0.49\u20130.69) were the strongest independent predictors. Subgroup analyses showed consistent associations across age, sex, and obesity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A favorable lifestyle, physical function, metabolic health, and comorbidity control, was strongly associated with lower cardiac and all\u2010cause mortality in patients with CHD, supporting multidimensional health management for secondary prevention of CHD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/clc.70378","type":"journal-article","created":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T17:21:47Z","timestamp":1781544107000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Association Between Comprehensive Health Assessment and Cardiac Mortality and All\u2010Cause Mortality in Patients With Coronary Heart Disease"],"prefix":"10.1002","volume":"49","author":[{"given":"Yanqiong","family":"Li","sequence":"first","affiliation":[{"name":"Internal Medicine Nursing Teaching and Research Section, School of Nursing Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lixia","family":"Yang","sequence":"additional","affiliation":[{"name":"Internal Medicine Nursing Teaching and Research Section, School of Nursing Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiaoyang","family":"Lu","sequence":"additional","affiliation":[{"name":"Internal Medicine Nursing Teaching and Research Section, School of Nursing Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yanhui","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nursing the First Affiliated Hospital of Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Cheng","sequence":"additional","affiliation":[{"name":"Internal Medicine Nursing Teaching and Research Section, School of Nursing Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhou","family":"Zuo","sequence":"additional","affiliation":[{"name":"Internal Medicine Nursing Teaching and Research Section, School of Nursing Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenlin","family":"Fu","sequence":"additional","affiliation":[{"name":"Internal Medicine Nursing Teaching and Research Section, School of Nursing Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7165-7789","authenticated-orcid":false,"given":"Peng","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Public Health Changsha Medical University Changsha Hunan China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_10_3_1","unstructured":"P.CfDCa. NHANES 1999\u20132018 Survey Documentation and Codebooks. In: Atlanta: CDC\/NCHS;2020."},{"key":"e_1_2_10_4_1","unstructured":"National Center for Health Statistics. The National Health and Nutrition Examination Survey accessed May 9 2024 https:\/\/www.cdc.gov\/nchs\/nhanes\/index.htm."},{"key":"e_1_2_10_5_1","unstructured":"World Health Organization. International Classification of Diseases 10th Revision (ICD\u201010). Geneva: WHO;2019."},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.0000437739.71477.ee"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021993"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.010710"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/01.cir.80.2.234"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e31823ac046"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.111.049122"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2020.05.006"}],"container-title":["Clinical Cardiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.70378","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/clc.70378","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/clc.70378","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T10:48:32Z","timestamp":1783162112000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/clc.70378"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,6]]}},"alternative-id":["10.1002\/clc.70378"],"URL":"https:\/\/doi.org\/10.1002\/clc.70378","archive":["Portico"],"relation":{},"ISSN":["0160-9289","1932-8737"],"issn-type":[{"value":"0160-9289","type":"print"},{"value":"1932-8737","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6]]},"assertion":[{"value":"2025-10-23","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-15","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70378"}}