Cardiovascular diseases confer major challenges globally in terms of public health, economic and social aspects. In the European Union, cardiovascular disease accounted for 1.7 million deaths in 2021, as well as the loss of 1.3 million working years. Among the various CVD, ischemic heart disease, most commonly caused by coronary artery disease, accounts for the highest percentage of mortality, being the cause of 34% of deaths in 2021. During the course of coronary artery disease exacerbations may occur in the form of acute coronary syndromes, which include a life-threatening ST-segment elevation myocardial infarction (STEMI), often induced by sudden coronary artery closure, and non-ST-segment elevation MI (NSTEMI), resulting from heterogeneous causes leading to an imbalance between myocardial oxygen demand and supply capabilities. In this study, we examined the influence of air pollution exposure on the risk of the aforementioned diseases.
What are the main findings of our work?
Higher NO2 and PM2·5 concentrations increased mid-term risk of NSTEMI in patients aged <65 years by 1.3-5.7%. Increased SO2 and PM2.5 concentration triggered STEMI in the short- (SO2, PM2.5) and mid-term (PM2.5) amongst those aged ≥65 years. In the short- and mid-term, women were more susceptible to PM2.5 and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO2, PM2.5 and BaP. Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%). There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors. Air pollution exposure is associated with the threat of a higher risks of NSTEMI and STEMI, especially to younger people, women, residents of rural areas and those with lower income.
The full article can be accessed at DOI: https://doi.org/10.1016/j.lanepe.2024.100910
PubMed: https://pubmed.ncbi.nlm.nih.gov/38665621/