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

Kuźma, Łukasz; Dąbrowski, Emil J; Kurasz, Anna; Święczkowski, Michał; Jemielita, Piotr; Kowalewski, Mariusz; Wańha, Wojciech; Kralisz, Paweł et al. · Lancet Reg Health Eur · 2024

retrospective_cohort · Level III

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Abstract

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. We analysed short- (lags up to seven days) and mid-term (0-30 days moving average) influence of particulate matter (PM<sub>2.5</sub>), sulphur dioxide (SO<sub>2</sub>), nitrogen dioxide (NO<sub>2</sub>) 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. Higher NO<sub>2</sub> and PM<sub>2.5</sub> concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3-5.7%. Increased SO<sub>2</sub> and PM<sub>2.5</sub> concentration triggered STEMI in the short- (SO<sub>2</sub>, PM<sub>2.5</sub>) and mid-term (PM<sub>2.5</sub>) amongst those aged ≥ 65 years. In the short- and mid-term, women were more susceptible to PM<sub>2.5</sub> and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO<sub>2</sub>, PM<sub>2.5</sub> 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. 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. National Science Center and Medical University of Bialystok, Poland.