Limits...
Ambient Particulate Matter (PM 2.5 /PM 10 ) Exposure and Emergency Department Visits for Acute Myocardial Infarction in Chaoyang District, Beijing, China During 2014: A Case-Crossover Study

View Article: PubMed Central - PubMed

ABSTRACT

Background: Epidemiology studies have shown a consistently increased risk of acute myocardial infarction (AMI) correlated with particulate matter (PM) exposure. However, little is known about the association with specific AMI subtypes. In this work, we investigated the association between short-term PM exposure and emergency department visits (EDVs) for AMI, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI).

Methods: We based this case-crossover study on 2749 patients from Chaoyang District hospitalized with AMI in Anzhen Hospital during 2014. Meteorological and air pollution data were collected during this period. We used a time-stratified case-crossover design with lag model, adjusted for meteorological conditions and/or other gaseous pollutants, to estimate risk of EDVs for AMI, STEMI, and NSTEMI. We conducted stratified analyses by gender, age, season, and comorbid conditions to examine potential effect modification.

Results: We found that each 10 µg/m3 increment of PM2.5 concentration (1-day lagged) was associated with an increased risk of EDVs for STEMI (OR 1.05; 95% CI, 1.00–1.11). We found no association of PM2.5 concentration with overall AMI or NSTEMI. No effect modification was found when stratified by gender, season, or comorbid conditions, even though the effect size was larger in patients who were male, smokers, and comorbid with hypertension. Patients aged ≥65 years showed a significantly increased risk of STEMI associated with PM2.5 in the previous day than those aged <65 years.

Conclusions: Our study indicated a transient effect of short-term PM2.5 exposure on EDVs for STEMI. Patients aged ≥65 years appeared to be particularly susceptible. Our findings suggest that studies of the association between PM exposure and AMI should consider AMI subtypes, lag times, and individual characteristics.

No MeSH data available.


Map of study area showing PM monitoring sites.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC5037251&req=5

fig01: Map of study area showing PM monitoring sites.

Mentions: Data on EDVs for AMI were gathered from residents of northern Chaoyang District who were hospitalized with AMI at Beijing Anzhen Hospital during 2014. Beijing Anzhen Hospital is the AMI-designated hospital for local residents in our study area (shown in Figure 1). All included cases lived within 10 km of our hospital. The information obtained for each case were name, age, gender, residence address, comorbid conditions, and clinical events. We excluded patients who were not currently living in this region and who had experienced other AMI events within 28 days prior. The data set included clinical events, pollutants, meteorological conditions, and individual characteristics, which were linked through admission date. We categorized admissions according to the primary diagnosis International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for AMI (I21.0–21.3), STEMI (I21.4), and NSTEMI (I20.0/20.1/20.9). This study was approved by the Beijing Anzhen Hospital Research Subjects Review Board.


Ambient Particulate Matter (PM 2.5 /PM 10 ) Exposure and Emergency Department Visits for Acute Myocardial Infarction in Chaoyang District, Beijing, China During 2014: A Case-Crossover Study
Map of study area showing PM monitoring sites.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037251&req=5

fig01: Map of study area showing PM monitoring sites.
Mentions: Data on EDVs for AMI were gathered from residents of northern Chaoyang District who were hospitalized with AMI at Beijing Anzhen Hospital during 2014. Beijing Anzhen Hospital is the AMI-designated hospital for local residents in our study area (shown in Figure 1). All included cases lived within 10 km of our hospital. The information obtained for each case were name, age, gender, residence address, comorbid conditions, and clinical events. We excluded patients who were not currently living in this region and who had experienced other AMI events within 28 days prior. The data set included clinical events, pollutants, meteorological conditions, and individual characteristics, which were linked through admission date. We categorized admissions according to the primary diagnosis International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes for AMI (I21.0–21.3), STEMI (I21.4), and NSTEMI (I20.0/20.1/20.9). This study was approved by the Beijing Anzhen Hospital Research Subjects Review Board.

View Article: PubMed Central - PubMed

ABSTRACT

Background: Epidemiology studies have shown a consistently increased risk of acute myocardial infarction (AMI) correlated with particulate matter (PM) exposure. However, little is known about the association with specific AMI subtypes. In this work, we investigated the association between short-term PM exposure and emergency department visits (EDVs) for AMI, ST-elevation myocardial infarction (STEMI), and non-ST-elevation myocardial infarction (NSTEMI).

Methods: We based this case-crossover study on 2749 patients from Chaoyang District hospitalized with AMI in Anzhen Hospital during 2014. Meteorological and air pollution data were collected during this period. We used a time-stratified case-crossover design with lag model, adjusted for meteorological conditions and/or other gaseous pollutants, to estimate risk of EDVs for AMI, STEMI, and NSTEMI. We conducted stratified analyses by gender, age, season, and comorbid conditions to examine potential effect modification.

Results: We found that each 10 µg/m3 increment of PM2.5 concentration (1-day lagged) was associated with an increased risk of EDVs for STEMI (OR 1.05; 95% CI, 1.00–1.11). We found no association of PM2.5 concentration with overall AMI or NSTEMI. No effect modification was found when stratified by gender, season, or comorbid conditions, even though the effect size was larger in patients who were male, smokers, and comorbid with hypertension. Patients aged ≥65 years showed a significantly increased risk of STEMI associated with PM2.5 in the previous day than those aged <65 years.

Conclusions: Our study indicated a transient effect of short-term PM2.5 exposure on EDVs for STEMI. Patients aged ≥65 years appeared to be particularly susceptible. Our findings suggest that studies of the association between PM exposure and AMI should consider AMI subtypes, lag times, and individual characteristics.

No MeSH data available.