Impact of air pollution on hospital patients admitted with ST- and non-ST-segment elevation myocardial infarction in heavily polluted cities within the European Union

Abstract

Background: Air pollution triggered diseases have become a leading health problem worldwide. The main adverse effects of air pollutants on human health are related to the cardiovascular system and particularly show an increasing prevalence of myocardial infarct and stroke. The aim of the study was to evaluate the influence of main air pollutants on non-ST-segment elevation myocardial infarction (NSTEMI) and ST-segment elevation myocardial infarction (STEMI) admissions to local interventional cardiology centers. Methods: Between 2014 and 2015, a multicenter registry of 1957 patients with acute myocardial infarction (STEMI, NSTEMI) admitted to interventional cardiology departments in three Polish cities were under investigation. The air pollution (PM2.5, PM10, NO2, SO2, O3) and weather conditions (temperature, barometric pressure, humidity) data for each city were collected as daily averages. The case-crossover design and conditional logistic regression were used to explore the association between acute myocardial infarctions and short-term air pollution exposure. Results: Occurrence of NSTEMI on the day of air pollution was triggered by PM2.5

Short-Term Effects of Air Pollution on Cardiovascular Hospitalizations in the Pisan Longitudinal Study

“…In our study, NO 2 exposure yielded the largest associations with CVD hospitalization for 2013-2015. Larger effects of NO 2 compared to PM were also found for MI hospitalizations (2014)(2015) in the three Polish industrial areas, showing about 29% higher risk (for a 10 µg/m 3 increase) at lag 0, and 26% higher risk at lag 1 [5]. In an Iranian study (2010-2012) carried out in an industrial urban area, a 10 µg/m 3 increase in NO 2 was associated with a 26% higher risk of all-age hospitalization for atrial fibrillation after 24 h, while no significant associations emerged for PM exposure [33].…”

“…In such a study, the risk of CVD hospitalization increased by 19.6% for a 10 µg/m 3 increase in PM 2.5 (lag 0) [11]. Moreover, a recent case-crossover study (2014)(2015) in highly polluted small/mediumsized industrial cities in southern Poland, reported a 16% increased risk of hospitalization for acute myocardial infarction per 10 µg/m 3 increase in PM 10 , and a 20% increased risk for PM 2.5 (lag 0) [5].…”

“…In a US study across the Mid-Atlantic, a short-term increase of 10 µg/m 3 in PM 2.5 was associated with a 0.78% increase in CVD admission rate in elderly people [4]. Exposure to nitrogen dioxide (NO 2 ) was also found to be a risk factor for myocardial infarction (MI) hospitalization (29% higher risk for a 10 µg/m 3 increase) in three industrial cities in southern Poland [5].…”

“…Despite the largely available evidence regarding the effects of air pollution on CVD hospitalizations, such effects have been scantly investigated in small urban and suburban areas. Indeed, most of the previously published studies were carried out in large (e.g., metropolitan) and/or highly polluted (e.g., industrial) areas [5][6][7][8][9], since a large amount of observed data are available from monitoring stations in such contexts. Consequently, generalizability may be limited and a selection bias may occur [4].…”

Exposure to air pollution and renal function - an underestimated threat?

“…Regardless of the source, according to the European Environment Agency, particulate matter contributes to the premature death of approximately 428,000 citizens of Europe every year [2]. There is a great deal of evidence in the literature for the short-and long-term adverse effects of air pollution on the cardiovascular and pulmonary systems [3][4][5][6][7][8][9][10][11][12][13]. The exact mechanisms associated with the impact of air pollution on the human body remain unclear.…”