Ambient air pollution is associated with the severity of coronary atherosclerosis and incident myocardial infarction in patients undergoing elective cardiac evaluation

Hartiala, J; Breton, CV; Tang, WH; Lurmann, F; Hazen, SL; Gilliland, FD; Allayee, H

HERO ID

3426450

Reference Type

Journal Article

Year

2016

Language

English

PMID

27468926

HERO ID 3426450
In Press No
Year 2016
Title Ambient air pollution is associated with the severity of coronary atherosclerosis and incident myocardial infarction in patients undergoing elective cardiac evaluation
Authors Hartiala, J; Breton, CV; Tang, WH; Lurmann, F; Hazen, SL; Gilliland, FD; Allayee, H
Journal Journal of the American Heart Association
Volume 5
Issue 8
Abstract <strong>BACKGROUND: </strong>The effect of air pollution exposure on atherosclerosis severity or incident clinical events in patients with coronary artery disease is not known.<br /><br /><strong>METHODS AND RESULTS: </strong>We conducted a prospective longitudinal cohort study of 6575 Ohio residents undergoing elective diagnostic coronary angiography. Multinomial regression and Cox proportional hazards models were used to assess the relationship between exposure to fine particulate matter <2.5 μm in diameter (PM2.5) and nitrogen dioxide on coronary artery disease severity at baseline and risk of myocardial infarction, stroke, or all-cause mortality over 3 years of follow-up. Among participants with coronary artery disease, exposure to PM2.5 levels was associated with increased likelihood of having coronary atherosclerosis that was mild (odds ratio 1.43, 95% CI 1.11-1.83, P=0.005) and severe (odds ratio 1.63, 95% CI 1.26-2.11, P<0.0001), with the effect on severe coronary artery disease being significantly increased compared with mild disease (Ptrend=0.03). Exposure to higher PM2.5 levels was also significantly associated with increased risk of incident myocardial infarction (hazard ratio 1.33, 95% CI 1.02-1.73, P=0.03) but not stroke or all-cause mortality. The association of PM2.5 with incident myocardial infarction was not affected after adjustment for Framingham Adult Treatment Panel III (ATP III) risk score or statin therapy. In comparison, there were no significant associations between nitrogen dioxide levels and all-cause mortality or risk of stroke after adjustment for Framingham ATP III risk score.<br /><br /><strong>CONCLUSIONS: </strong>Exposure to PM2.5 increased the likelihood of having severe coronary artery disease and the risk of incident myocardial infarction among patients undergoing elective cardiac evaluation. These results suggest that ambient air pollution exposure may be a modifiable risk factor for risk of myocardial infarction in a highly susceptible patient population.
Doi 10.1161/JAHA.116.003947
Pmid 27468926
Wosid WOS:000386714900047
Is Certified Translation No
Dupe Override No
Is Public Yes
Language Text English