TY - JOUR
T1 - Association between ambient particulate matter air pollution and ST-elevation myocardial infarction
T2 - A case-crossover study in a Chinese city
AU - Li, Jiading
AU - Liu, Cong
AU - Cheng, Yuexin
AU - Guo, Shumei
AU - Sun, Qian
AU - Kan, Lena
AU - Chen, Renjie
AU - Kan, Haidong
AU - Bai, Hongjian
AU - Cao, Jingyan
N1 - Funding Information:
The study was supported by the China Medical Board Collaborating Program ( 16–250 ), and the Shanghai 3-Year Public Health Action Plan ( GWTD 2015S04 and 15GWZK0202 ).
Funding Information:
The study was supported by the China Medical Board Collaborating Program (16–250), and the Shanghai 3-Year Public Health Action Plan (GWTD 2015S04 and 15GWZK0202).
Publisher Copyright:
© 2018 Elsevier Ltd
PY - 2019/3
Y1 - 2019/3
N2 - Background: Abundant epidemiological studies have revealed that short-term exposure to ambient air pollution increased the incidence of ischemic heart diseases. However, few investigations have explored the association between air pollution and ST-elevation myocardial infarction (STEMI), one major subtype of such events. Methods: We conducted a time-stratified case-crossover study in two major hospitals of Yancheng, a city in East China, from January 2015 to February 2018. We used conditional logistic regression models to explore the association between hourly concentrations of air pollutants and STEMI hospitalizations. We explored potential effect modification in susceptible subgroups by age, gender, smoking status, and comorbidities. Two-pollutant models were fitted to test the robustness of the association. Results: We identified a total of 347 STEMI patients. In single-pollutant models, each 10 μg/m3 increase in concentrations of fine and inhalable particulate matter (PM) (lag 13–24 h) was associated with increments of 5.27% [95% confidence interval (CI): 1.09%, 9.46%] and 3.86% (95%CI: 0.83%, 6.88%) in STEMI hospitalizations, respectively. We observed slightly larger associations of STEMI hospitalization with PM in patients who were older than 65, female, non-smoker, and with comorbidities (hypertension, diabetes or hyperlipidemia). The associations were generally robust to adjustment of criteria gaseous pollutants except for carbon monoxide. Conclusion: This is the first study in China that suggested acute exposure to elevated PM concentrations may trigger STEMI. Patients with cardiometabolic comorbidities were slightly more susceptible to air pollution.
AB - Background: Abundant epidemiological studies have revealed that short-term exposure to ambient air pollution increased the incidence of ischemic heart diseases. However, few investigations have explored the association between air pollution and ST-elevation myocardial infarction (STEMI), one major subtype of such events. Methods: We conducted a time-stratified case-crossover study in two major hospitals of Yancheng, a city in East China, from January 2015 to February 2018. We used conditional logistic regression models to explore the association between hourly concentrations of air pollutants and STEMI hospitalizations. We explored potential effect modification in susceptible subgroups by age, gender, smoking status, and comorbidities. Two-pollutant models were fitted to test the robustness of the association. Results: We identified a total of 347 STEMI patients. In single-pollutant models, each 10 μg/m3 increase in concentrations of fine and inhalable particulate matter (PM) (lag 13–24 h) was associated with increments of 5.27% [95% confidence interval (CI): 1.09%, 9.46%] and 3.86% (95%CI: 0.83%, 6.88%) in STEMI hospitalizations, respectively. We observed slightly larger associations of STEMI hospitalization with PM in patients who were older than 65, female, non-smoker, and with comorbidities (hypertension, diabetes or hyperlipidemia). The associations were generally robust to adjustment of criteria gaseous pollutants except for carbon monoxide. Conclusion: This is the first study in China that suggested acute exposure to elevated PM concentrations may trigger STEMI. Patients with cardiometabolic comorbidities were slightly more susceptible to air pollution.
KW - Air pollution
KW - Case-crossover study
KW - Particulate matter
KW - ST-elevation myocardial infarction
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U2 - 10.1016/j.chemosphere.2018.12.094
DO - 10.1016/j.chemosphere.2018.12.094
M3 - Article
C2 - 30557729
AN - SCOPUS:85058405530
SN - 0045-6535
VL - 219
SP - 724
EP - 729
JO - Chemosphere
JF - Chemosphere
ER -