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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.


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Time series of mean daily EDVs for AMI, STEMI and NSTEMI during 2014. AMI, acute myocardial infarction; EDV: emergency department visit; NSTEMI, non-ST-elevation myocardial infarction; STEMI, ST-elevation myocardial infarction.
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fig02: Time series of mean daily EDVs for AMI, STEMI and NSTEMI during 2014. AMI, acute myocardial infarction; EDV: emergency department visit; NSTEMI, non-ST-elevation myocardial infarction; STEMI, ST-elevation myocardial infarction.

Mentions: During the study period, a total of 2749 patients from our study area who were admitted to Beijing Anzhen Hospital diagnosed with AMI (1016 STEMI patients and 1733 NSTEMI patients) were included in our analysis. As is shown in Table 1, about 58.64%, 62.30%, and 56.49% of the cases were male and 54.60%, 48.52%, and 58.17% of the cases were aged ≥65 years for AMI, STEMI, NSTEMI, respectively. The proportions of patients with a history of smoking, hypertension, and diabetes were 56.86%, 60.86%, and 30.48%, respectively. Figure 2 showed the time series descriptive statistics of EDVs for AMI, STEMI, and NSTEMI from January 1 through December 31, 2014.


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
Time series of mean daily EDVs for AMI, STEMI and NSTEMI during 2014. AMI, acute myocardial infarction; EDV: emergency department visit; NSTEMI, non-ST-elevation myocardial infarction; STEMI, ST-elevation myocardial infarction.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig02: Time series of mean daily EDVs for AMI, STEMI and NSTEMI during 2014. AMI, acute myocardial infarction; EDV: emergency department visit; NSTEMI, non-ST-elevation myocardial infarction; STEMI, ST-elevation myocardial infarction.
Mentions: During the study period, a total of 2749 patients from our study area who were admitted to Beijing Anzhen Hospital diagnosed with AMI (1016 STEMI patients and 1733 NSTEMI patients) were included in our analysis. As is shown in Table 1, about 58.64%, 62.30%, and 56.49% of the cases were male and 54.60%, 48.52%, and 58.17% of the cases were aged ≥65 years for AMI, STEMI, NSTEMI, respectively. The proportions of patients with a history of smoking, hypertension, and diabetes were 56.86%, 60.86%, and 30.48%, respectively. Figure 2 showed the time series descriptive statistics of EDVs for AMI, STEMI, and NSTEMI from January 1 through December 31, 2014.

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.


Related in: MedlinePlus