Long-term exposure of fine particulate matter air pollution and incident atrial fibrillation in the general population: A nationwide cohort study

A time‐to‐event analysis on air pollutants with the risk of cardiovascular disease and mortality: A systematic review and meta‐analysis of 84 cohort studies

“…After assessing 58 full‐text for eligibility; we excluded nine studies because of: (1) no PM 2.5 data for the hypertension outcome ( n = 3), (2) increments for the pollutant concentration was change from previous concentration/place ( n = 2), (3) no clear data on hazard ratio, only in a diagram without precise data on hazard ratio and confidence interval ( n = 1), and (4) no specific data on pollutants, only distance from highways/road ( n = 3) (Figure 1). We included 49 articles in qualitative and quantitative synthesis; 5 articles were a joint cohort studies comprising of 2 (Dehbi 2017), 2 (Stockfelt 2018), 3 (Cai 2018), 11 (ESCAPE 2014), and 22 (Beelen 2014) cohorts, adding up to a total of 84 cohorts 1,3,5‐7,9‐52 . There were a total of 28 215 394 subjects from 84 cohorts.…”

Long-term PM2.5 exposure and the clinical application of machine learning for predicting incident atrial fibrillation

“…Although some studies, including our previous study 8 , have shown the relationships between air pollution exposure and AF development in patients with known cardiac diseases 27 , some studies from Western countries did not show a relationship between PM 2.5 exposure and incident AF 11,12 . However, these studies were performed in European countries and the United States, where the air pollution levels were much lower than the levels in Asian countries.…”

“…(Supplementary Table 3). We have previously reported on the association between increased exposure to longterm average PM 2.5 and increased incidence of AF 8 25 were independent risk factors for incident AF (Table 3). According to these multivariable Cox regression analyses, PM 2.5 ≥ 15 μg/m 3 (HRs 1.1-1.4) was pointed as 1 compared with HRs of other clinical variables and added this to existing CHA 2 DS 2 -VASc, CHADS 2 , and HATCH systems, then we developed new simple PM-CHA 2 DS 2 -VASc, PM-CHADS 2 , and PM-HATCH scores ( Table 3).…”

“…Some scoring systems for predicting incident AF have been introduced, including the CHADS 2 3 , CHA 2 DS 2 -VASc 4 , and HATCH 5 scores; however, their prediction accuracies are not sufficient for wide application. Although epidemiological studies have suggested that an elevated level of ambient particulate matter < 2.5 μm in aerodynamic diameter (PM 2.5 ) is consistently associated with adverse cardiac events 6 and arrhythmias 7 , including AF 8 , the role of PM 2.5 on incident AF remains to be investigated. Recently, data-driven analyses using machine learning (ML) methods have been introduced to identify some blood biomarkers that are risk factors of AF prevalence (not incidence) 9 , and they were considered non-inferior to traditional analyses 9 , 10 .…”

Long-term fine particulate matter exposure and cardiovascular mortality in the general population: a nationwide cohort study

“…In addition, we could not identify the exact hour of subjects' death or specific events because this study was from the claims data. For these reasons, the analysis of acute exposure effects was thought as it may draw somewhat biased results from our cohort data, and further investigations are needed [34]. Compared to the previous epidemiological study [32] which was performed with the Medicare population primarily consisting of subjects older than 65 years and cause-specific mortality were not reported, our study included young healthy subjects and investigated the associations between PM 2.5 exposure and cardiovascular mortality also.…”