{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:45:48Z","timestamp":1782992748303,"version":"3.54.5"},"reference-count":36,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Patients with atrial fibrillation (AF) remain exposed to residual thromboembolic and cardiovascular risk despite oral anticoagulation. The Atherogenic Index of Plasma (AIP) reflects atherogenic burden, but its prognostic value in anticoagulated AF is uncertain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This prospective cohort study included consecutive outpatients with AF initiating oral anticoagulation between January 2016 and November 2021. AIP was calculated from baseline triglyceride and high\u2010density lipoprotein cholesterol levels. Patients were stratified into low and high AIP groups using an outcome\u2010driven cut\u2010off. Primary outcomes were thromboembolic events and major adverse cardiovascular events. Secondary outcomes included cardiovascular and all\u2010cause death. Associations were assessed using restricted cubic spline models and multivariable Cox regression analyses adjusted for AF\u2010related comorbidities and concomitant therapies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Among 2535 patients (52.4% women; median age, 76\u2009years [interquartile range, 69\u201382\u2009years]) followed up for 1.81\u00b10.50\u2009years, thromboembolic events occurred in 187 (7.4%) and major adverse cardiovascular events in 254 (10.0%). Restricted cubic spline models showed significant nonlinear associations with thromboembolic events (overall\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; nonlinear\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.007) and major adverse cardiovascular events (overall\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001; nonlinear\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.040). High AIP was independently associated with an increased risk of thromboembolic events after adjustment for conventional comorbidities (model 1: adjusted hazard ratio [aHR], 1.47 [95% CI, 1.07\u20132.02]), with the association remaining significant after further adjustment for commonly prescribed concomitant treatments (model 2: aHR, 1.38 [95% CI, 1.01\u20131.88]). Similar results were observed for major adverse cardiovascular events (model 1: aHR, 1.40 [95% CI, 1.07\u20131.84]; model 2: aHR, 1.35 [95% CI, 1.03\u20131.76]). No significant associations were found for mortality outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Elevated AIP identifies anticoagulated patients with AF at increased residual thromboembolic and cardiovascular risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.046694","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T10:41:21Z","timestamp":1773139281000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Atherogenic Index of Plasma and Residual Risk in Anticoagulated Patients With Atrial Fibrillation: The Prospective Murcia Atrial Fibrillation Project III Cohort"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-4864","authenticated-orcid":false,"given":"Eva","family":"Soler\u2010Espejo","sequence":"first","affiliation":[{"name":"Instituto Murciano de Investigaci\u00f3n Biosanitaria, University of Murcia","place":["Murcia, Spain"]},{"name":"Liverpool John Moores University and Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2808-6286","authenticated-orcid":false,"given":"Yang","family":"Chen","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University and Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0492-6241","authenticated-orcid":false,"given":"Jos\u00e9 M.","family":"Rivera\u2010Caravaca","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University and Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]},{"name":"CIBERCV, University of Murcia","place":["Murcia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4528-0845","authenticated-orcid":false,"given":"Mar\u00eda P.","family":"Ramos\u2010Bratos","sequence":"additional","affiliation":[{"name":"CIBERCV, University of Murcia","place":["Murcia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7246-7708","authenticated-orcid":false,"given":"Francisco","family":"Mar\u00edn","sequence":"additional","affiliation":[{"name":"CIBERCV, University of Murcia","place":["Murcia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4945-6602","authenticated-orcid":false,"given":"Vanessa","family":"Rold\u00e1n","sequence":"additional","affiliation":[{"name":"Instituto Murciano de Investigaci\u00f3n Biosanitaria, University of Murcia","place":["Murcia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool John Moores University and Liverpool Heart and Chest Hospital","place":["Liverpool, UK"]},{"name":"Aalborg University","place":["Aalborg, Denmark"]},{"name":"Medical University of Bialystok","place":["Bialystok, Poland"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100786"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2023.100797"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1111\/eci.14371"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-0042-1756355"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.123.034758"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm10153357"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02359-z"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02144-y"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-01886-5"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3389\/fendo.2024.1360874"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-01936-y"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02163-9"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-02589-9"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-02044-7"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.rec.2021.07.009"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.09-1584"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2024.100967"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-0134"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00592-021-01801-y"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-023-01740-8"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1111\/dom.70335"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-025-02927-x"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajcnut.2025.101184"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1093\/cvr\/cvab017"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2019.07.006"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.122.026410"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurjpc\/zwaf287"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.hrthm.2025.09.003"},{"key":"e_1_3_2_30_2","doi-asserted-by":"publisher","DOI":"10.1155\/2023\/1966680"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehae710"},{"key":"e_1_3_2_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2022.113634"},{"key":"e_1_3_2_33_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41590-023-01479-0"},{"key":"e_1_3_2_34_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrcardio.2015.2"},{"key":"e_1_3_2_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02314-y"},{"key":"e_1_3_2_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12933-024-02350-8"},{"key":"e_1_3_2_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12944-025-02552-3"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.046694","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T11:09:38Z","timestamp":1782990578000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.046694"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,17]]},"references-count":36,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,3,17]]}},"alternative-id":["10.1161\/JAHA.125.046694"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.046694","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,17]]},"assertion":[{"value":"2025-09-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-30","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-03-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e046694"}}