Air pollution and short‐term clinical outcomes of patients with acute myocardial infarction. (June 2017)

• Record Type: Journal Article
• Authors: Lee, Min Woo; Choi, Byoung Geol; Kim, Suhng Wook; Rha, Seung‐Woon; Shim, Min Suk; Kim, Dae Jin; Seo, Hong Seog; Oh, Dong Joo; Jeong, Myung ho
• Other Names: Kim Yong Hoon investigator.; Kim Young Jo investigator.; Kim Chong Jin investigator.; Cho Myeong Chan investigator.; Ahn Youngkeun investigator.; Kim Jong Hyun investigator.; Chae Shung Chull investigator.; Hur Seung Ho investigator.; Seong In Whan investigator.; Hong Taek Jong investigator.; Choi Dong Hoon investigator.; Chae Jei Keon investigator.; Rhew Jae Young investigator.; Kim Doo Il investigator.; Chae In Ho investigator.; Yoon Jung Han investigator.; Koo Bon Kwon investigator.; Kim Byung Ok investigator.; Lee Myoung Yong investigator.; Kim Kee Sik investigator.; Hwang Jin Yong investigator.; Oh Seok Kyu investigator.; Lee Nae Hee investigator.; Jeong Kyoung Tae investigator.; Tahk Seung Jea investigator.; Bae Jang Ho investigator.; Park Keum Soo investigator.; Han Kyoo Rok investigator.; Ahn Tae Hoon investigator.; Kim Moo Hyun investigator.; Yang Joo Young investigator.; Rhim Chong Yun investigator.; Gwon Hyeon Cheol investigator.; Park Seong Wook investigator.; Koh Young Youp investigator.; Joo Seung Jae investigator.; Kim Soo Joong investigator.; Jin Dong Kyu investigator.; Cho Jin Man investigator.; Chung Wook Sung investigator.; Jang Yang Soo investigator.; Cho Jeong Gwan investigator.; Seung Ki Bae investigator.; Park Seung Jung investigator.;
• Is Part Of: Clinical and experimental pharmacology and physiology. Volume 44:Number 6(2017:Jun.)
• Page Start: 631
• Page End: 638
• Publication Date: 2017-06
• Subjects: Acute myocardial infarction -- air pollutant -- air pollution -- particular matter; Clinical pharmacology -- Periodicals; Pharmacology, Experimental -- Periodicals; Physiology, Experimental -- Periodicals; Physiology, Pathological -- Periodicals; 615.1
• DOI: 10.1111/1440-1681.12755
• Languages: English
• ISSNs: 0305-1870

Abstract

Summary: Ambient air pollution is well‐known to be a serious risk factor for cardiovascular diseases, stroke, and death. However, the association between air pollutants (AP) exposure and short‐term clinical outcomes in acute myocardial infarction (AMI) patients (pts) has not been elucidated well. In the present study, 37 880 AMI pts were enrolled from October 2005 to December 2013 in a nationwide large‐scale, prospective, multicentre Korea AMI registry (KAMIR registry;http://www.kamir.or.kr ). We obtained data on AP (e.g., NO2, SO2, CO, O3 and PM10 ) from the Korean National Institute of Environmental Research (NIER;http://www.nier.go.kr ). Clinical endpoints included death, recurrent myocardial infarction (Re‐MI), any revascularization and composite of all‐cause death and Re‐MI. Exposure to AP is defined as the average exposure to AP within 24 hours before AMI admission. We observed that a 0.01 part per million (ppm) increase in NO2 concentration, 0.001 ppm increase in SO2 concentration, and 0.1 ppm increase in CO concentration each increased the risk of total death by 9.7% (95% CI, 6.2%‐13.4%), 1.9% (95% CI, 0.3%‐3.6%), and 2.1% (95% CI, 0.5%‐3.9%), respectively. Exceptionally, O3 decreased the risk of total death by 0.6% (95% CI −0.2% to −1.0%) per 0.01 ppm increase. PM10 was not related to any cardiovascular events. AP were each stratified into five quintiles according to ranges of AP levels. After adjusting analysis for risk variables, only high quintiles (Q4, Q5) of NO2 were positively associated with total death, cardiac death and MI, while SO2, CO, O3 and PM10 were shown to be not related to any cardiovascular events at all levels. In AMI patients, each AP and its concentration has shown a different effect to short‐term mortality and cardiovascular events.