Abstract
Background: We investigated the effect of particulate matter with aerodynamic diameter <2.5 μm (PM2.5) and meteorological conditions on the risk of emergency room visits in patients with atrial fibrillation (AF) in Beijing, which is considered as a monsoon climate region.Methods: In this case-crossover design study, medical records from patients with AF who visited the Critical Care Center in the Emergency Department of Anzhen Hospital from January 2011 through December 2014 and air quality and meteorological data of Beijing during the same period were collected and analyzed using Cox regression and time-series autocorrelation analyses.Results: A total of 8,241 patients were included. When the average PM2.5 concentration was >430 μg/m3, the risk of emergency room visits for patients with uncomplicated AF, AF combined with cardiac insufficiency, and AF combined with rheumatic heart disease increased by 12, 12, and 40%, respectively. When the average PM2.5 concentration was >420 μg/m3, patients with AF combined with diabetes mellitus had a 75% increased risk of emergency room visits, which was the largest increase in risk among all types of patients with AF. When the average PM2.5 concentration was >390 μg/m3, patients with AF combined with acute coronary syndrome had an approximately 30% increased risk of emergency room visits, which was the highest and fastest increase in risk among all types of patients with AF. The risk of emergency room visits for patients with AF was positively correlated with air quality as the time lag proceeded, with an autocorrelation coefficient of 0.223 between the risk of emergency room visits and air quality in patients with AF on day 6 of the time lag.Conclusion: Exposure to certain concentrations of PM2.5 in a monsoon climate region significantly increased the risk of emergency room visits in patients with AF.
Highlights
With the advancement in industrialization, air pollution is on the rise
When the average PM2.5 concentration was >430 μg/m3, the risk of emergency room visits for patients with uncomplicated atrial fibrillation (AF), AF combined with cardiac insufficiency, and AF combined with rheumatic heart disease increased by 12, 12, and 40%, respectively
When the average PM2.5 concentration was >420 μg/m3, patients with AF combined with diabetes mellitus had a 75% increased risk of emergency room visits, which was the largest increase in risk among all types of patients with AF
Summary
With the advancement in industrialization, air pollution is on the rise. The increase in the concentration of various pollutants, such as PM2.5, has been closely associated with various diseases, including lung, cardiovascular, kidney, and eye diseases, according to an increasing number of studies [1,2,3,4]. Epidemiological studies have shown that air pollution is associated with the development of cardiovascular disease (CVD) [6, 7]. A study on the link between CVD and air pollution particulate matter found that a 10 μg/m3 increase in PM concentration was associated with a 4% and 10% increase in the incidence of total CVD and ischemic heart disease, respectively [8]. The number of CVD hospitalizations increased with increases in air pollution index [9]. These studies suggested that exposure to a certain concentration of PM2.5 may significantly increase morbidity, hospitalization rates, and mortality rates of patients with CVD and that reducing PM2.5 exposure may improve cardiovascular event outcomes [10]. We investigated the effect of particulate matter with aerodynamic diameter
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