{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T16:22:50Z","timestamp":1783441370922,"version":"3.54.6"},"reference-count":38,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/501100010198","name":"Spanish Ministry of Economy, Industry, and Competitiveness","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010198","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos","doi-asserted-by":"publisher","award":["PI17\/01375"],"award-info":[{"award-number":["PI17\/01375"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100009569","name":"Autonomous Community of the Region of Murcia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009569","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Generation of New Scientific"},{"DOI":"10.13039\/501100008430","name":"J\u00f3venes L\u00edderes en Investigaci\u00f3n","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100008430","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100011958","name":"Transition to Independent Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100011958","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002923","name":"Scientific and Technical Research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002923","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007801","name":"Seneca Foundation-Science and Technology Agency of the Region of Murcia","doi-asserted-by":"publisher","award":["21919\/JLI\/22"],"award-info":[{"award-number":["21919\/JLI\/22"]}],"id":[{"id":"10.13039\/100007801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Managing modifiable risk factors and adherence to a healthy lifestyle are key in the holistic integrated care management of atrial fibrillation (AF). This study examines the relationship between a baseline healthy lifestyle and adverse clinical outcomes in AF patients.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We included AF patients starting oral anticoagulation (OAC) between January 2016 and November 2021. Adherence to a healthy lifestyle was assessed at baseline using five modifiable lifestyle factors and patients were categorized into three groups based on points of adherence to modifiable factors: poor (0-8 points); moderate (9-12 points); high (13-17 points). The primary outcome was a composite of ischemic events, over a 2-years follow-up.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>3,266 AF patients were included (median age 77 [IQR 70-83] years), 52.8% female), and of these, 906 (27.7%) had high adherence. Incidence rate ratios were significantly lower in both the moderate adherence group (0.61; 95% CI 0.46-0.80) and the high adherence group (0.59; 95% CI 0.42-0.81) compared to the poor adherence group. Cox regression analyses adjusted for OAC type showed that high adherence to a healthy lifestyle significantly reduced the risk of composite ischemic events (aHR 0.58; 95% CI 0.42-0.79; p&amp;lt;0.001). After adjusting for additional risk factors, high adherence remained associated with lower risk of ischemic events (aHR 0.59; 95% CI 0.42-0.81; p=0.001). Similar results were observed for the secondary endpoints of MACE and ischemic stroke\/TIA\/systemic embolism; and in competing risk regression analyses.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>High baseline adherence to a healthy lifestyle reduced the risk of ischemic and major cardiovascular events in AF patients.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurjpc\/zwaf287","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T17:08:38Z","timestamp":1747242518000},"source":"Crossref","is-referenced-by-count":6,"title":["Association between baseline adherence to a healthy lifestyle with ischemic and major cardiovascular events in patients with atrial fibrillation"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-4864","authenticated-orcid":false,"given":"Eva","family":"Soler-Espejo","sequence":"first","affiliation":[{"name":"Department of Hematology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca) , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Pilar","family":"Ramos-Bratos","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca), CIBERCV , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Gonz\u00e1lez-Lozano","sequence":"additional","affiliation":[{"name":"Professional Development Unit, Servicio Murciano de Salud , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y H","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre of Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart and Chest Hospital , Liverpool ,","place":["United Kingdom"]},{"name":"Department of Clinical Medicine, Aalborg University , Aalborg \u00a0","place":["Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca), CIBERCV , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0492-6241","authenticated-orcid":false,"given":"Jos\u00e9 Miguel","family":"Rivera-Caravaca","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine, Aalborg University , Aalborg \u00a0","place":["Denmark"]},{"name":"Faculty of Nursing, University of Murcia , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Department of Hematology, Hospital Cl\u00ednico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigaci\u00f3n Biosanitaria (IMIB-Arrixaca) , Murcia ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"2025052311272284300_zwaf287-B1","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1161\/CIRCRESAHA.120.316340","article-title":"Epidemiology of atrial fibrillation in the 21st century: novel methods and new 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