Short-Term Association Between Ambient Air Pollution and Risk of Hospitalization for Acute Myocardial Infarction: Results of the Cardiovascular Risk and Air Pollution in Tuscany (RISCAT) Study

Abstract

Air pollutant levels have been widely associated with increased hospitalizations and mortality from cardiovascular disease. In this study, the authors focused on pollutant levels and triggering of acute myocardial infarction (AMI). Data on AMI hospitalizations, air quality, and meteorologic conditions were collected in 6 urban areas of Tuscany (central Italy) during 2002-2005. Levels of particulate matter with an aerodynamic diameter ≤10 μm (PM(10)) (range of 4-year mean values, 28.15-40.68 μg/m(3)), nitrogen dioxide (range, 28.52-39.72 μg/m(3)), and carbon monoxide (range, 0.86-1.28 mg/m(3)) were considered, and increases of 10 μg/m(3) (0.1 mg/m(3) for carbon monoxide) were analyzed. A time-stratified case-crossover approach was applied. Area-specific conditional regression models were fitted, adjusting for time-dependent variables. Stratified analyses and analyses in bipollutant models were performed. Pooled estimates were derived from random-effects meta-analyses. Among 11,450 AMI hospitalizations, the meta-analytical odds ratio at lag(2) (2-day lag) was 1.013 (95% confidence interval (CI): 1.000, 1.026) for PM(10), 1.022 (95% CI: 1.004, 1.041) for nitrogen dioxide, and 1.007 (95% CI: 1.002, 1.013) for carbon monoxide. More susceptible subgroups were elderly persons (age ≥75 years), females, and older patients with hypertension and chronic obstructive pulmonary disease. This study adds to evidence for a short-term association between air pollutants and AMI onset, also evident at low pollutant levels, suggesting a need to focus on more vulnerable subjects.

Air pollution and cardiovascular hospital admissions in Kerman, Iran

“…Some epidemiological studies have been conducted on the relationship between air pollution and cardiovascular disease such as a study performed by Barchielli et al in 2011 in Italy that estimated the correlation between air pollutants (CO, NO 2 and PM 10 ) with cardiovascular mortality and acute myocardial infarction hospital admissions. In this study the elderly, women and patients with a history of chronic lung disease and blood pressure were at higher risk and increase in the level of pollutants was associated with increased referrals of acute myocardial infarction patients to hospitals [28] . Another study done by Michelle et al in 2009 in America investigated the chemical composition of fine particulate matter (PM 2.5 ) and the effects of these particles on health and cardiovascular hospital admissions and showed that whenever the composition of particulate nickel, vanadium and carbon compounds in ambient air increased, cardiovascular hospital admissions increased as well [29] .…”

Independent and combined interaction of fine particulate matter in atmospheric air and the frequency of acute myocardial infarction hospitalizations in Varna, Bulgaria

“…Another research group has also reported increased sensitivity of this population group [9]. Significant linear regression correlations were established not only in the AMI patients at retirement age, but also in the younger group of patients -those The potential toxicity of ozone and sulfur dioxide in combination with particular matter exposure has also been an object of active research.…”

New Insights Into Pollution and the Cardiovascular System

“…106,107 As chronic obstructive pulmonary disease is classified more carefully and specifically, there will be better opportunity to evaluate the susceptibility of people with chronic obstructive pulmonary disease.…”