Abstract
The American Heart Association has updated the cardiovascular health (CVH) assessment tool, referred to as the Life's Essential 8 (LE8). Metabolic dysfunction-associated steatotic liver disease (MASLD) is now the most common chronic liver disease worldwide and is linked to an elevated risk of mortality. We aimed to explore the association of LE8 with all cause and cause-specific mortality in MASLD in a prospective cohort study. A total of 10,050 participants with MASLD from the NHANES 2005-2018 dataset were included in the study. LE8 was evaluated by combining four health behaviors and four health factors, with scores of 0-49 categorized as low CVH, 50-79 as moderate CVH, and 80-100 as high CVH. In the fully adjusted model, each one-point increase in the LE8 score corresponded to a 2.7, 2.7, and 1.6% decrease in all-cause, CVD, and cancer mortality risk, respectively, in people with MASLD. Compared to low CVH, being in moderate/high CVH was negatively associated with most mortality outcomes, while health factors lost significant association with cancer mortality.