Sex-Specific Associations between Long-term Air Pollution Exposure and Coronary Atherosclerosis at Cardiac CT.
retrospective_cohort · Level III
Where this comes from
- Record sourced from PubMed, PMID 42262238.
- Also identified by DOI 10.1148/radiol.252086.
- No licence information is recorded for this record.
- Because redistribution is not established, this page shows the abstract only. Follow the links below for the full text.
Abstract
Background Air pollution is the leading environmental risk factor for cardiovascular disease. However, data regarding its association with coronary artery disease (CAD) beyond coronary artery calcium score (CACS) remain limited. Purpose To evaluate the relationship between long-term exposure to particulate and gaseous air pollutants and CT markers of CAD stratified by sex. Materials and Methods Adult patients who underwent outpatient cardiac CT for CAD evaluation between January 2012 and December 2023 were included in this multisite retrospective study. CACS, total plaque burden, and presence of obstructive CAD (≥70% diameter stenosis) were evaluated. Mean exposure to fine particulate matter (particulate matter measuring ≤2.5 µm in diameter [PM<sub>2.5</sub>]) and NO<sub>2</sub> air pollution was assessed over the 10-year period before cardiac CT. Negative binomial (CACS), ordinal logistic (plaque burden), and logistic (obstructive CAD) regression models were constructed and adjusted for clinically relevant covariates. Results Overall, 11 128 patients who underwent cardiac CT were included (mean age, 59.1 years ± 11.3 [SD]; 5754 [51.7%] men), among whom 7313 patients (mean age, 59.5 years ± 11.5; 3561 [48.7%] men) underwent coronary CT angiography. The median 10-year exposure was 7.5 μg/m<sup>3</sup> (range, 4.3-9.2 μg/m<sup>3</sup>) for PM<sub>2.5</sub> and 13.4 parts per billion (ppb) (range, 3.2-17.8 ppb) for NO<sub>2</sub>. Greater PM<sub>2.5</sub> and NO<sub>2</sub> exposures were associated with greater CACS (PM<sub>2.5</sub>: incidence rate ratio (IRR) = 1.11, <i>P</i> < .001; NO<sub>2</sub>: IRR = 1.01, <i>P</i> = .04) and total plaque burden (PM<sub>2.5</sub>: odds ratio [OR] = 1.13, <i>P</i> = .02; NO<sub>2</sub>: OR = 1.04, <i>P</i> < .001) according to multivariable analysis. In maximally adjusted models stratified by sex, long-term air pollution exposure was associated with obstructive CAD in women (PM<sub>2.5</sub>: OR = 1.81, <i>P</i> = .048; NO<sub>2</sub>: OR = 1.06, <i>P</i> = .04); however, there was no evidence of an association in men (PM<sub>2.5</sub>: OR = 1.14, <i>P</i> = .38; NO<sub>2</sub>: OR = 1.03, <i>P</i> = .13). Conclusion Long-term exposure to PM<sub>2.5</sub> and NO<sub>2</sub> is independently associated with more advanced coronary atherosclerosis at cardiac CT, even at moderate contemporary exposure levels. © RSNA, 2026.