Figure
Spearman correlations between physical and medical variables. Statistically significant correlations are underlined (P<0.05).
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Introduction:
Air pollution is a documented risk factor for circulatory diseases.
Objectives:
To assess the influence of air pollution on the number of hospital admissions for acute coronary syndrome (ACS) in elderly patients.
Patients and methods:
The medical records of 26,695 patients hospitalized for ACS in the Department of Invasive Cardio...
Context in source publication
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Previous studies have reported that air pollution negatively affects the tourism industry. This paper attempted to answer the following question: among different air pollutants, which one acts as the most adverse factor? The study was based on a sample of panel data covering 337 Chinese cities for the period between 2007 and 2016. Four pollutant in...
Citations
... Over the years, evidence of associations between air pollution and numerous cardiovascular diseases has also been established. Increased exposure to pollutants, especially particulate matter (PM), is associated with a higher incidence of acute coronary syndromes in the overall population and in the elderly [33,34]. A meta-analysis of more than 23 million participants showed a positive association between air pollution and an increased risk of hospital admission due to stroke [35]. ...
Air pollution is a pervasive global challenge with profound implications for public health. This review explores the intricate relationship between air pollution and atrial fibrillation (AF), a prevalent cardiac arrhythmia associated with significant morbidity and mortality. Drawing on a comprehensive analysis of the existing literature, this review synthesizes current evidence linking various air pollutants, including particulate matter, nitrogen dioxide, ozone, and carbon monoxide, to the development and exacerbation of AF. The review delves into the role of air pollution as a global health issue alongside its specific sources, such as traffic-related emissions and industrial pollutants. It also examines the underlying mechanisms through which air pollution may contribute to the pathogenesis of AF, encompassing oxidative stress, inflammation, and autonomic nervous system dysregulation. In addition, it explores the impact of individual pollutants and the results of meta-analyses. It considers the results of vulnerable populations, including sex differences between the individuals and those with pre-existing cardiovascular conditions, who may be disproportionately affected. We also address critical research gaps in this area. Overall, air pollution has been increasingly recognized as a significant trigger for AF, with evidence linking exposure to particulate matter and gaseous pollutants to an increased incidence in short- as well as long-term exposure, highlighting the need for targeted public health interventions and further research to mitigate its cardiovascular impact.
... Evidence increasingly highlights the pronounced effects of PM10 and CO on coronary artery disease. An Italian study demonstrated that PM10 exposure elevates the risk of ACS 17 . A large case-crossover study in China from 2013 to 2018 found that short-term exposure to PM10 significantly increased the risk of death from acute myocardial infarction 18 . ...
... A 2023 systematic review and metaanalysis revealed that short-term exposure to PM10 and CO heightens the risk of angina 20 . Epidemiological data suggest that higher PM10 concentrations correlate with a higher incidence of UA among elderly patients 17 . Lin et al. ...
Cardiovascular disease remains the leading cause of death worldwide, with air pollution’s impact on cardiovascular health being closely monitored. However, the specific effects of air pollution on the risk of hospital readmission for heart failure (HF) in patients with unstable angina (UA) have not been fully explored. We conducted a retrospective study involving 12,857 consecutive patients diagnosed with acute coronary syndrome (ACS) between January 2015 and March 2023. After rigorous screening, we included 8,737 patients with UA in the analysis. Furthermore, we used a Cox proportional hazards regression model to examine the relationship between air quality indicators and hospital readmission for HF in patients with UA. Additionally, a decision tree model identified air quality indicators levels that had the most significant impact on readmission for HF risk. After adjusting for confounding factors, we found that elevated levels of PM10 [hazard ratio (HR) = 1.003, 95% confidence interval (CI): 1.000-1.005, p = 0.04453] and CO (HR = 1.013, 95% CI: 1.005–1.021, p = 0.00216) were associated with an increased risk of hospital readmission for HF in UA patients. Specifically, patients exposed to PM10 levels above 112.5 µ g/m³ had a 1.61-fold higher risk of readmission for HF in UA patients. (HR = 1.609, 95% CI: 1.190–2.176, p = 0.00201), and those exposed to CO levels above 37.5 mg/m³ had a 2.70-fold higher risk of readmission for HF in UA patients. (HR = 2.681, 95% CI: 1.731–4.152, p < 0.00001). Higher concentrations of PM10 and CO significantly increased the risk of HF (HF) readmission in patients with UA after discharge, particularly when PM10 levels exceeded 112.5 ug/m³ and CO levels surpassed 37.5 ug/m³. Besides, female patients with UA, with fewer underlying diseases, were more susceptible to the adverse effects of PM10 and CO.
... Konduracka et al [19] presented an increased daily number of hospital admissions related to short-term increases in PM2.5 levels, while the PM10 effect was significant with a simultaneous decrease in temperature in a southern large city in Poland. Kuzma et al [18,20] showed a higher incidence of hospitalizations due to acute coronary syndrome associated with air pollution in the eastern part of Poland, especially in younger subjects, females, residents of rural areas, and those with lower incomes. Similarly, an increased risk of hospital admissions was proved for the influence of air pollution on exacerbations of chronic obstructive pulmonary disease [21]. ...
... Subsequent investigations consistently highlight that exposure to air pollutants, whether over short or long periods, significantly contributes to negative outcomes in cardio-respiratory conditions [10][11][12][13][14][15][16][17]. Earlier epidemiological discoveries specifically emphasize the heightened detrimental effects of PM on CVD compared to other airborne pollutants, especially in cases of increased exposure to PM 2.5 [10,[13][14][15][16][17][18][19][20]. ...
... The epidemiological evidence has substantiated the adverse impact of PM 10 on cardiovascular health, showcasing an increased occurrence of UA cases in elderly patients following a 10 µg/m 3 rise in PM 10 concentration [19]. Findings from an Italian study indicated a 1.1% elevation in ACS risk for every 14 µg/m 3 increase in PM 10 and a 2.3% increase for each 10 µg/m 3 rise in PM 2.5 [18]. ...
In the context of recent climate change, global warming, industrial growth, and population expansion, air pollution has emerged as a significant environmental and human health risk. This study employed a multivariable Poisson regression analysis to examine the association between short-term exposure to atmospheric pollutants (nitrogen dioxide—NO2, sulfur dioxide -SO2, ozone—O3, and particulate matter with a diameter less than 10 μm-PM10) and hospital admissions for non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Daily data on NSTE-ACS admissions, air pollutants, and meteorological variables were collected from January 2019 to December 2021. Elevated NO2 concentrations were associated with a higher risk of NSTE-ACS hospitalization, notably in spring (OR: 1.426; 95% CI: 1.196–1.701). Hypertensive individuals (OR: 1.101; 95% CI: 1.007–1.204) and those diagnosed with unstable angina (OR: 1.107; 95%CI: 1.010–1.213) exhibited heightened susceptibility to elevated NO2 concentrations. A 10 μg/m³ increase in NO2 during spring at lag 07 (OR: 1.013; 95% CI: 1.001–1.025) and O3 in winter at lag 05 (OR: 1.007; 95% CI: 1.001–1.014) was correlated with an elevated daily occurrence of NSTE-ACS admissions. Short-term exposure to various air pollutants posed an increased risk of NSTE-ACS hospitalization, with heightened sensitivity observed in hypertensive patients and those with unstable angina. Addressing emerging environmental risk factors is crucial to mitigate substantial impacts on human health and the environment.
... [37]. Therefore, public health policies and governments should pay more attention to air quality, as the air-pollution-related burden of disease is significant [38,39,40]. Moreover, people in more polluted regions should know about their poorer diagnosis. ...
Introduction:
Clinical remission in type 1 diabetes (T1D) results from metabolic compensation after insulin implementation and is caused by various factors.
Objectives:
Our aim was to investigate an association between air pollution defined based on ozone concentration in the month of T1D diagnosis and the early course of the disease, that is, glucose metabolism and the occurrence of remission.
Patients and methods:
This prospective, observational analysis included 96 adult patients with newly diagnosed T1D. The study group was divided according to the occurrence of remission at 12 months after the diagnosis. The levels of ambient ozone measured within the month of T1D diagnosis were calculated using the official data of Poland's Chief Inspectorate of Environmental Protection. Remission was defined according to the following formula: actual glycated hemoglobin (HbA1c)(%) level + [4 × insulin dose (units/kg per 24 h)] - value defining partial remission ≤9.
Results:
The remission rate after 12 months was higher in the group where ozone concentration was below or equal to the median for the study population (P <0.001). Moreover, the patients in the group where ozone levels were above the median, presented lower C‑peptide levels (P = 0.01), higher HbA1c concentration (P = 0.005), and higher daily insulin requirements (P = 0.02) after 12 months from the diagnosis. Also, in the group of participants achieving remission, the ambient ozone level was lower (P <0.001). In a multivariable logistic regression analysis, the increased ozone concentration in the month of diagnosis was the variable that influenced the lack of remission after 12 months, independently of sex and smoking (P <0.001).
Conclusions:
Increased ozone level may exacerbate metabolic outcomes and reduce remission in T1D.
... In the study of two cohorts (the PPS cohort and the GOT-MONICA cohort), Stockfelt et al. received a positive association between both PM10 and PM2.5 for ischemic heart disease and heart failure for only one of the cohorts, whereas the results for the other cohort were insignificant [23]. Our results are in accordance with the findings of Kuźma et al., who observed a significant effect of particulate matter exposure to cardiovascular disease hospitalizations as well as to CVD deaths [24,25]. ...
(1) Background: More than 1.8 million people in the European Union die every year as a result of CVD, accounting for 36% of all deaths with a large proportion being premature (before the age of 65). There are more than 300 different risk factors of CVD, known and air pollution is one of them. The aim of this study was to investigate whether daily cardiovascular mortality was associated with air pollutants and meteorological conditions in an urban environment with a low level of air pollution. (2) Methods: Data on daily incidence of strokes and myocardial infarctions in the city of Gdansk were obtained from the National Health Fund (NHF) and covered the period from 1 January 2014 to 31 December 2018. Data on the level of pollution, i.e., SO2, NO, NO2, NOx, CO, PM10, PM2.5, CO2, O3 and meteorological conditions came from the foundation: Agency of Regional Air Quality Monitoring in the Gdańsk metropolitan area (ARMAG). Using these data, we calculated mean values with standard deviation (SD) and derived the minimum and maximum values and interquartile range (IQR). Time series regression with Poisson distribution was used in statistical analysis. (4) Results: Stroke incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.019 (95%CI: 1.001–1.036), 1.036 (95%CI: 1.008–1.064) and 1.017 (95%CI: 1.000–1.034) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Similarly, myocardial infarction incidence is significantly affected by an increase in concentrations of NO, NO2 and NOx with RRs equal to 1.030 (95%CI: 1.011–1.048), 1.053 (95%CI: 1.024–1.082) and 1.027 (95%CI: 1.010–1.045) for every increase in IQR by 14.12, 14.62 and 22.62 μg/m3, respectively. Both PM10 and PM2.5 were positively associated with myocardial infarction incidence. (5) Conclusions: In this time-series cross-sectional study, we found strong evidence that support the hypothesis that transient elevations in ambient PM2.5, PM10, NO2, SO2 and CO are associated with higher relative risk of ischemic stroke and myocardial infarction incidents.
... The second study included 1618 elderly inhabitants of Białystok in Poland with a mean age of 75 years [15]. Elevated PM 10 levels were associated with a higher num- 10 concentrations by 10 μg/m 3 was associated with an increase in the number of hospitalizations due to unstable angina, and significant effects were observed even after 6 days (rate ratio, 1.16; 95% CI: 1.03-1.32; ...
The EP-PARTICLES study was created to assess the impact of air pollution on the health and mortality of the population of Eastern Poland. The biggest cities of the region are Lublin, Białystok, Olsztyn, Rzeszow, and Kielce, whose inhabitants constitute less than 25% of the total population of the analyzed region. The vast majority of air pollution studies to date have been conducted in heavily polluted areas, where patients are exposed to moderate to extreme concentrations of pollutants. The composition of the pollution itself is also not without significance, as it differs significantly from the types of smog we are familiar with. The type of air pollution known as Polish smog is rich in compounds such as PM2.5, PM10, and polycyclic aromatic hydrocarbons (benzo(a)pyrene) from low emissions associated with household heating with solid fuels (coal, wood, and often also waste) and imposes detrimental effects on the health and life of the population, in particular in the context of cardiovascular effects. In this publication, we aimed to present the baseline results of the EP-PARTICLES investigators’ research up to this point and propose steps aimed at changing the state of air quality and reducing existing exposure. Fields covered so far include atrial fibrillation, acute coronary syndromes, ischemic stroke, heart failure, renal function, and cardiovascular mortality.
... Eighthly, we were not able to obtain reliable information on the smoking status, diabetes therapy, and changes in pharmacotherapy during follow-up. Lastly, none of these scores take into account external factors, such as air pollution or climate change, which have a large impact on cardiovascular morbidity and mortality [10,33]. ...
Rapid scoring systems validated in patients with atrial fibrillation (AF) may be useful beyond their original purpose. Our aim was to assess the utility of CHA2DS2-VASc, HAS–BLED, and 2MACE scores in predicting long-term mortality in the population of the Białystok Coronary Project, including AF patients. The initial study population consisted of 7409 consecutive patients admitted for elective coronary angiography between 2007 and 2016. The study endpoint was all-cause mortality, which occurred in 1244 (16.8%) patients during the follow-up, ranging from 1283 to 3059 days (median 2029 days). We noticed substantially increased all-cause mortality in patients with higher values of all compared scores. The accuracy of the scores in predicting all-cause mortality was also assessed using the receiver operator characteristic (ROC) curves. The greatest predictive value for mortality was recorded for the CHA2DS2-VASc score in the overall study population (area under curve [AUC] = 0.665; 95% confidence interval [95%CI] 0.645–0.681). We observed that the 2MACE score (AUC = 0.656; 95%CI 0.619–0.681), but not the HAS–BLED score, had similar predictive value to the CHA2DS2-VASc score for all-cause mortality in the overall study population. In AF patients, all scores did not differ in all-cause mortality prediction. Additionally, we found that study participants with CHA2DS2-VASc score ≥3 vs. <3 had a 3-fold increased risk of long-term all-cause mortality (odds ratio 3.05; 95%CI 2.6–3.6). Our study indicates that clinical scores initially validated in AF patients may be useful for predicting mortality in a broader population (e.g., in patients referred for elective coronary angiography). According to our findings, all compared scores have a moderate predictive value. However, in our study, the CHA2DS2-VASc and 2MACE scores outperformed the HAS–BLED score in terms of the long-term all-cause mortality prediction.
... PM 10 were associated with an increased risk of ACS in Italy, China, New York, and Poland [74][75][76][77][78]. In Italy, a 10 μg/m 3 increase in PM 2.5 levels caused a 2.3% rise in the risk of ACS, while in China, high concentrations of PM 2.5 determined an increase in cardiovascular morbidity and mortality [74,75]. ...
... In New York, each 7.1 μg/m 3 increase in PM 2.5 concentration was associated with an 18% increase in STEMI risk [76]. A 10 μg /m 3 increase in PM 10 concentration was associated with high UA hospitalizations [77]. In industrial areas of Poland, exposure to high levels of gaseous pollutants (NO 2 , SO 2 , CO) and fine particulate matter (PM 10 , PM 2.5 ) increased the incidence of STEMI, while NSTEMI hospitalizations were related to high NO 2 concentrations in both industrial and non-industrial areas [78]. ...
Purpose of Review
Several studies have found that air pollution and climate change can have an impact on acute coronary syndromes (ACS), the leading cause of death worldwide. We synthesized the latest information about the impact of air pollution and climate change on ACS, the latest data about the pathophysiological mechanisms of meteorological factors and atmospheric pollutants on atherosclerotic disease, and an overall image of air pollution and coronary heart disease in the context of the COVID-19 pandemic.
Recent Findings
The variation of meteorological factors in different seasons increased the risk of ACS. Both the increase and the decrease in apparent temperature were found to be risk factors for ACS admissions. It was also demonstrated that exposure to high concentrations of air pollutants, especially particulate matter, increased cardiovascular morbidity and mortality.
Summary
Climate change as well as increased emissions of air pollutants have a major impact on ACS. The industrialization era and the growing population cause a constant increase in air pollution worldwide. Thus, the number of ACS favored by air pollution and the variations in meteorological factors is expected to increase dramatically in the next few years.
... Activation of the inflammatory cytokines, oxidative stress, and adhesion molecules results in atherosclerosis [4][5][6]. Previous reports revealed a significant association between high ambient particulate matter and an increased incidence of cardiovascular disease including ischemic stroke [7,8], acute coronary syndrome [9][10][11], and thrombosis [12][13][14]. ...
... PM is defined according to particle size. Coarse particulate matter, PM 10 has an aerodynamic diameter of between 2.5 to 10 microns. Fine particulate matter, PM 2.5 has a particle size of more than 0.1 micron, but less than 2.5 microns in aerodynamic diameter. ...
Ambient air pollution has become a common problem worldwide. Exposure to pollutant particles causes many health conditions, having a particular impact on pulmonary and cardiovascular disease. Increased understanding of the pathological processes related to these conditions may facilitate the prevention of the adverse impact of air pollution on our physical health. Evidence from in vitro, in vivo, and clinical studies has consistently shown that exposure to particulate matter could induce the inflammatory responses such as IL-6, TNF-α, IL-1β, as well as enhancing the oxidative stress. These result in vascular injury, adhesion molecule release, platelet activation, and thrombin generation, ultimately leading to a prothrombotic state. In this review, evidence on the effects of particulate matter on inflammation, oxidative stress, adhesion molecules, and coagulation pathways in enhancing the risk of thrombosis is comprehensively summarized and discussed. The currently available outcomes of interventional studies at a cellular level and clinical reports are also presented and discussed.
