{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T14:11:04Z","timestamp":1792591864656,"version":"4.5.0"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"20","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">The predictive value of Life's Crucial 9 (LC9), a recently proposed cardiovascular health risk score combining psychological health and Life's Essential 8 (LE8), remains unclear.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In this cohort study, we included 16\u2009290 adults without cardiovascular disease from the 2007 to 2018 cycles of NHANES (National Health and Nutrition Examination Survey). The LC9 was the mean of the LE8 score and the depression score, which represented a dimension of psychological health. The study outcomes were cardiovascular and all\u2010cause mortality. Cox proportional hazard models were fitted to estimate the association of LC9 and LE8 scores with outcomes. The differences in Harrell's concordance index, net reclassification improvement index, and integrated discrimination improvement were calculated to assess the predictive ability of the depression score in addition to the LE8 score. During a median follow\u2010up of 7.08\u2009years, 879 (5.40%) participants died, and 242 (1.49%) died from cardiovascular disease. The adjusted hazard ratio (HR) of per LE8 10\u2010score increase for cardiovascular mortality was 0.80 (95% CI, 0.72\u20130.88;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001) and the adjusted HR of per LC9 10\u2010score increase was 0.77 (95% CI, 0.69\u20130.86;\n              <jats:italic>P<\/jats:italic>\n              &lt;0.001). Adding the depression score to the LE8 score, the improvement in concordance index for cardiovascular mortality was 0.001 (95% CI, \u22120.001 to 0.003;\n              <jats:italic>P<\/jats:italic>\n              =0.30), the net reclassification improvement index was 10.6% (95% CI, \u22127.6% to 18.9%;\n              <jats:italic>P<\/jats:italic>\n              =0.073), and the IDI was 0.002 (95% CI, 0.000\u20130.007;\n              <jats:italic>P<\/jats:italic>\n              =0.033). The results for all\u2010cause mortality showed similar patterns.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Compared with the LE8, the improvement in the predictive value of LC9 was negligible. It may not be necessary to add a depression score to the current cardiovascular health score.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.124.036669","type":"journal-article","created":{"date-parts":[[2024,10,8]],"date-time":"2024-10-08T16:10:29Z","timestamp":1728403829000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":77,"title":["Predictive Value of Life's Crucial 9 for Cardiovascular and All\u2010Cause Mortality: A Prospective Cohort Study From the NHANES 2007 to 2018"],"prefix":"10.1161","volume":"13","author":[{"given":"Jinzhuo","family":"Ge","sequence":"first","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenyao","family":"Peng","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9179-4587","authenticated-orcid":false,"given":"Jiapeng","family":"Lu","sequence":"additional","affiliation":[{"name":"National Clinical Research Center for Cardiovascular Diseases, NHC Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.109.192703"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000001078"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2023.01.021"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/jaha.123.030764"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/strokeaha.123.042525"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-023-02824-8"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12967-022-03839-0"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2023.08.007"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamda.2023.05.023"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2023.0015"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(18)32408-5"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0140-6736(20)30925-9"},{"key":"e_1_3_2_14_2","unstructured":"WHO . 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