Associations of Life’s Essential 8 and fine particulate matter pollution with the incidence of atrial fibrillation

Both unhealthy lifestyle factors and ambient air pollution have been closely linked with the risk of atrial fibrillation (AF). We retrieved 250,898 participants without AF at baseline from UK Biobank. LE8 was determined by 8 metrics, and was characterized as low, moderate and high cardiovascular health (CVH). Exposure to PM2.5 was estimated at the geocoded residential address of each participant. During a median follow-up of 12.46 years, we identified 14,743 (5.9%) incident AF cases. Participants with moderate and high CVH showed a decreased risk of incident AF compared to those with low CVH. Of the LE8 metrics, ideal body mass index (BMI) and blood pressure (BP) were associated with a decrease of 11.57% and 11.46% AF cases. High PM2.5 exposure was associated with an 8% increased risk of AF as compared to low PM2.5 exposure. Compared with those who had low CVH and high PM2.5 exposure, participants with a high CVH and low PM2.5 exposure had the lower AF incidence. Our study found higher CVH is protective, while higher PM2.5 might be one risk factor of AF. Adherence to the LE8 guidelines may help reduce the incidence of AF, especially in those with lower PM2.5 exposure.