背景 对于癌症幸存者中心血管健康（CVH）与全因、心血管疾病（CVD）和癌症死亡风险之间的剂量反应关系知之甚少。目的 我们旨在研究 CVH 与全因死亡率、CVD 和癌症死亡率之间的剂量反应关系。方法 通过国家健康和营养检查调查 (NHANES)，从 2007 年到 2018 年，对 1701 名美国成年癌症幸存者进行了中位随访 7.3 年（IQR 4.0-10.2）。我们使用美国心脏协会 (AHA) Life's Essential 8 (LE8) 作为 CVH 的代表。结果 受限三次样条模型表明，LE8 评分与全因死亡率之间的剂量反应关系呈近似逆线性形状，风险显着降低，范围在 61.25 之间（风险比 [HR]：0.76，95% CI，0.59- 0.98）和 100 分（HR：0.28，95％CI，0.12-0.62），以及 LE8 评分与 CVD 死亡之间剂量反应关联的曲线形状，风险显着降低在 50.25 范围内（HR：0.72，95） % CI，0.52-0.99）和 90.25 点（HR：0.15，95% CI，0.02-0.98）。 LE8 与癌症死亡之间没有观察到显着的剂量反应关联。结论 我们的研究表明，较高的 LE8 与全因死亡风险之间存在密切的负相关关系，较高的 LE8 与 CVD 死亡风险之间存在负曲线关系，而较高的 LE8 与癌症死亡风险之间不存在显着相关性。美国成年癌症幸存者，这可能意味着每年可避免大量死亡，从而对公共健康产生重要影响。版权所有 © 2023。由 Elsevier Inc. 出版。

Background There is little knowledge on the dose-response association between cardiovascular health (CVH) and risk of all-cause, cardiovascular disease (CVD) and cancer deaths among cancer survivors. Aims We aimed to examine the dose-response association of CVH with all-cause, CVD, and cancer mortality. Methods A total of 1701 US adult cancer survivors were followed-up during a median of 7.3 (IQR 4.0-10.2) years from 2007 to 2018 through the National Health and Nutrition Examination Survey (NHANES). We used the American Heart Association´s (AHA) Life´s Essential 8 (LE8) as a proxy for CVH. Results Restricted cubic spline models indicated a close to inverse linear shape for the dose-response association between LE8 score and all-cause mortality with significant risk reductions within the range between 61.25 (Hazard ratio [HR]: 0.76, 95% CI, 0.59-0.98) and 100 points (HR: 0.28, 95%CI, 0.12-0.62), and a curvilinear shape for the dose-response association between LE8 score and CVD deaths with significant risk reductions within the range between 50.25 (HR: 0.72, 95% CI, 0.52-0.99) and 90.25 points (HR: 0.15, 95%CI, 0.02-0.98). No significant dose-response association was observed between LE8 and cancer deaths. Conclusions Our study showed a close to inverse relationship between higher LE8 and risk of death from all cause, an inverse curvilinear relationship between higher LE8 and the risk for CVD death, and a non-significant association between higher LE8 and the risk of cancer death among US adult cancer survivors, which may translate to a substantial number of annual averted deaths and thus important public health implications.Copyright © 2023. Published by Elsevier Inc.