Abstract
Background: Air pollution exposure is associated with greater risk for cardiovascular events. This study aims to examine the effects of increased exposure to short-term air pollutants on ST-segment elevation myocardial infarction (STEMI) and determine the susceptible groups. Methods: Data on particulate matter PM2.5 and PM10 and other air pollutants, measured at each of the 11 air-quality monitoring stations in Kaohsiung City, were collected between 2011 and 2016. The medical records of non-trauma adult (>17 years) patients who had visited the emergency department (ED) with a typical electrocardiogram change of STEMI were extracted. A time-stratified and case-crossover study design was used to examine the relationship between air pollutants and daily ED visits for STEMI. Results: An interquartile range increment in PM2.5 on lag 0 was associated with an increment of 25.5% (95% confidence interval, 2.6%–53.4%) in the risk of STEMI ED visits. Men and persons with ≥3 risk factors (male sex, age, hypertension, diabetes, current smoker, dyslipidemia, history of myocardial infarction, and high body mass index) for myocardial infarction (MI) were more sensitive to the hazardous effects of PM2.5 (interaction: p = 0.039 and p = 0.018, respectively). The associations between PM10, NO2, and O3 and STEMI did not achieve statistical significance. Conclusion: PM2.5 may play an important role in STEMI events on the day of exposure in Kaohsiung. Men and persons with ≥3 risk factors of MI are more susceptible to the adverse effects of PM2.5 on STEMI.
Highlights
Myocardial infarction (MI) is one of the major causes of mortality in the world
The inclusion criteria were a diagnosis meeting the criteria of segment elevation myocardial infarction (STEMI) on the basis of American College of Cardiology/American Heart Association guidelines [19], diagnosis confirmed by a cardiologist, and emergency primary percutaneous coronary intervention (PCI) performed with clinical evidence of coronary artery occlusion
Of all air pollutant exposures included in the analysis, the risk of STEMI following PM2.5 exposure was greater in men and in patients included in the analysis, the risk of STEMI following PM2.5 exposure was greater in men and in patients with more than three myocardial infarction (MI) risk factors
Summary
Myocardial infarction (MI) is one of the major causes of mortality in the world. MIs usually result from coronary thrombosis, which is caused by a ruptured or eroded atherosclerotic plaque that results in a sudden and serious reduction in blood flow [1]. STEMI is most often the result of plaque rupture with the complete blockage of a coronary artery, for which timely reperfusion therapy is recommended [2]. NSTEMI typically occurs due to coronary artery occlusion, as a consequence of excessive plaque burden with myocardial ischemia or the formation. Air pollution exposure is associated with greater risk for cardiovascular events. This study aims to examine the effects of increased exposure to short-term air pollutants on ST-segment elevation myocardial infarction (STEMI) and determine the susceptible groups. A time-stratified and case-crossover study design was used to examine the relationship between air pollutants and daily ED visits for STEMI. Men and persons with ≥3 risk factors (male sex, age, hypertension, diabetes, current smoker, dyslipidemia, history of myocardial infarction, and high body mass index) for myocardial infarction (MI) were more sensitive to the hazardous effects of PM2.5 (interaction: p = 0.039 and p = 0.018, respectively). Men and persons with ≥3 risk factors of MI are more susceptible to the adverse effects of PM2.5 on STEMI
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