Myocardial infarction triggered by exposure to air pollution – underestimated or overrated issue – 11 years study

Abstract

Abstract Introduction Currently, the greatest threat to the health and life of people and the leading cause of death in Poland are cardiovascular diseases (CVD). Air quality is a well-known risk factor for the development of them. Purpose The aim of this study is to assess the impact of air pollution on the frequency of hospital admissions due to acute coronary syndrome (ACS). Methods The medical records of 30,695 patients hospitalized in the Department of Invasive Cardiology were analyzed. Patients treated for ACS and living within the borders of the analyzed city met inclusion criteria. Weather conditions such as temperature, humidity, atmospheric pressure, wind speed and the following components of air pollution were analyzed: carbon monoxide (CO), sulfur dioxide (SO2), nitrogen dioxide (NO2), trioxygen (O3), particulate matter with a diameter of 2.5 μm or less (PM2.5) and with a diameter of 10 μm or less (PM10). Poisson regression was used for statistical analysis. Results The study included 3,325 inhabitants of analyzed city (mean age 66.2 years, SD=12.2), male in majority (60.3%). The number of patients admitted for ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina (UA) was 1002, 1265, and 1058, respectively. An increase of CO concentration by 1 g/m3 was associated with a higher number of admissions due to NSTEMI (RR 1.74; 95% CI, 1.08–2.8; P=0.02), this effect was more noticeable in the female population (RR - 2.8; 95% CI, 1.39–5.65; P=0.004). In male subjects an increase in the concentration of PM2.5 by 10 μg/m3 was associated with a 0.5% increase in the number of admissions for NSTEMI (RR 1.05, 95% CI 1.02–1.22; P=0.02) and UA (OR 1.14, 95% CI 1.02–1.25; P=0.014). An increase in the concentration of SO2 by 1 μg/m3 affected the frequency of admissions in men due to NSTEMI (0.5% increase, RR 1.04, 95% CI 1.01–1.07; P=0.007) and UA (OR 1.17, 95% CI 1.02–1.36; P=0.031). The concentration of 03 and NO2 did not affect admissions rate due to ACS. Conclusions Air quality had an impact on the occurrence of ACS among residents of Bialystok. Increased exposure to air pollution, in particular, elevated PM2.5, SO2 and CO levels, was associated with a higher incidence of NSTEMI and UA. This effect was more noticeable in the male population. Funding Acknowledgement Type of funding source: None