Effect of air pollution exposure on risk of acute coronary syndromes in Poland: a nationwide population-based study (EP-PARTICLES study)

Lukasz Kuzma, Emil J. Dabrowski*, Anna Kurasz, Michal Swieczkowski, Piotr Jemielita, Mariusz Kowalewski, Wojciech Wanha, Pawel Kralisz, Anna Tomaszuk-Kazberuk, Hanna Bachórzewska-Gajewska, Slawomir Dobrzycki, Gregory Y.H. Lip

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Air pollution (AP) is linked up to 20% of cardiovascular deaths. The aim of this nationwide study was to investigate subpopulations vulnerable to AP for non-ST- (NSTEMI) and ST-elevation myocardial infarction (STEMI) incidence. Methods: We analysed short- (lags up to seven days) and mid-term (0–30 days moving average) influence of particulate matter (PM 2.5), sulphur dioxide (SO 2), nitrogen dioxide (NO 2) and benzo(a)pyrene (BaP) on hospitalizations due NSTEMI and STEMI in 2011–2020. Data on AP concentrations were derived using GEM-AQ model. Study included residents of five voivodeships in eastern Poland, inhabited by over 8,000,000 individuals. Findings: Higher NO 2 and PM 2.5 concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3–5.7%. Increased SO 2 and PM 2.5 concentration triggered STEMI in the short- (SO 2, PM 2.5) and mid-term (PM 2.5) amongst those aged ≥ 65 years. In the short- and mid-term, women were more susceptible to PM 2.5 and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO 2, PM 2.5 and BaP. Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%). Interpretation: There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors. AP 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. Funding: National Science Center and Medical University of Bialystok, Poland.

Original languageEnglish
Article number100910
JournalThe Lancet Regional Health – Europe
Volume41
DOIs
Publication statusPublished - 1 Jun 2024

Keywords

  • Acute coronary syndrome
  • Air pollution
  • Cardiology
  • Myocardial infarction
  • Public health

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