Air pollution and short‐term clinical outcomes of patients with acute myocardial infarction

Abstract

Ambient air pollution is well-known to be a serious risk factor for cardiovascular diseases, stroke, and death. However, the association between air pollutants (AP) exposure and short-term clinical outcomes in acute myocardial infarction (AMI) patients (pts) has not been elucidated well. In the present study, 37 880 AMI pts were enrolled from October 2005 to December 2013 in a nationwide large-scale, prospective, multicentre Korea AMI registry (KAMIR registry; http://www.kamir.or.kr). We obtained data on AP (e.g., NO , SO , CO, O and PM ) from the Korean National Institute of Environmental Research (NIER; http://www.nier.go.kr). Clinical endpoints included death, recurrent myocardial infarction (Re-MI), any revascularization and composite of all-cause death and Re-MI. Exposure to AP is defined as the average exposure to AP within 24 hours before AMI admission. We observed that a 0.01 part per million (ppm) increase in NO concentration, 0.001 ppm increase in SO concentration, and 0.1 ppm increase in CO concentration each increased the risk of total death by 9.7% (95% CI, 6.2%-13.4%), 1.9% (95% CI, 0.3%-3.6%), and 2.1% (95% CI, 0.5%-3.9%), respectively. Exceptionally, O decreased the risk of total death by 0.6% (95% CI -0.2% to -1.0%) per 0.01 ppm increase. PM was not related to any cardiovascular events. AP were each stratified into five quintiles according to ranges of AP levels. After adjusting analysis for risk variables, only high quintiles (Q4, Q5) of NO were positively associated with total death, cardiac death and MI, while SO , CO, O and PM were shown to be not related to any cardiovascular events at all levels. In AMI patients, each AP and its concentration has shown a different effect to short-term mortality and cardiovascular events.

Association of air pollution and 1-year clinical outcomes of patients with acute myocardial infarction

“…The data was collected from the Korea Acute Myocardial Infarction (KAMIR) and KAMIR-National Institutes of Health (KAMIR-NIH). The KAMIR study design has been introduced in previous studies [ 12 , 13 ]. KAMIR and KAMIR-NIH are a nationwide prospective multicenter registration study series that aims to establish treatment guidelines and derive risk factors through various clinical characteristics and follow-up of Korean AMI patients from October 2005.…”

“…Our previous study investigated the association between short-term clinical outcomes and AP exposure in AMI patients. We found that AP exposure within 24 h before AMI admission was associated with mortality and cardiovascular events [ 12 ]. This study was conducted via an extended period of clinical follow-up and AP concentration data as a serial study followed by our previous study and aimed to evaluate the clinical effects of ambient AP concentration in AMI patients using nationwide prospective multicenter registry data.…”

The Impact of Short-Term Outdoor Air Pollution on Clinical Status and Prognosis of Hospitalized Patients with Coronary Artery Disease Treated with Percutaneous Coronary Intervention

“…Moreover, an increased chronic and short-term concentration of air pollutants is associated with more frequent manifestations of cardiovascular diseases. In some large-population registries and meta-analyses, the relationship between worse air quality and coronary artery disease (CAD) has been shown [7][8][9][10][11][12][13][14][15][16][17].…”

Short-Term Effects of Air Pollution on Coronary Events in Strasbourg, France—Importance of Seasonal Variations

“…Ref. [1][2][3] Various projections have estimated that outdoor air pollution may be responsible of 3.3 million premature deaths per year worldwide, predominantly in Asia. Ref.…”