The association of air pollutants exposure with subclinical inflammation and carotid atherosclerosis. (1st November 2021)

• Record Type: Journal Article
• Authors: Oikonomou, Evangelos; Lazaros, George; Mystakidi, Vasiliki Chara; Papaioannou, Nikolaos; Theofilis, Panagiotis; Vogiatzi, Georgia; Chasikidis, Christos; Fountoulakis, Petros; Papakostantinou, Maria-Argentina; Assimakopoulos, Margarita Niki; Barmparesos, Nikolaos; Tasios, Panagiotis; Kaski, Juan C.; Tousoulis, Dimitris
• Is Part Of: International journal of cardiology. Volume 342(2021)
• Page Start: 108
• Page End: 114
• Publication Date: 2021-11-01
• Subjects: Atherosclerosis -- Air pollution -- Carotid plaques -- Intima-media thickness -- Inflammation; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2021.07.056
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: Air pollution is a well-described environmental factor with evidence suggesting a firm association with cardiovascular diseases. The purpose of this study was to determine the association of exposure to gaseous air pollutants on atherosclerosis burden. Methods: 1955 inhabitants of the Corinthia region, aged 40 years or older, underwent clinical and biochemical assessment as well as carotid ultrasonography to evaluate carotid intima-media thickness (cIMT) and plaque burden. Analyzers recording time series concentration of CO, NO2, and SO2 were located at 4 different open sites (Regions 1, 2, 3 and 4) based on their proximity to industries, highways or shipyards. Results: A higher concentration of CO, NO2, and SO2 was observed in Region 4 compared to the other regions. Mean cIMT (Region 1: 0.93 ± 0.24 mm; Region 2: 0.96 ± 0.40 mm; Region 3: 0.94 ± 0.39 mm; Region 4: 1.14 ± 0.55 mm, p < 0.001), maximum cIMT ( p < 0.001) as well as carotid plaque burden (Region 1: 13.3%; Region 2: 18.8%; Region 3: 22.4%; Region 4: 38.6%, p < 0.001) were significantly higher in individuals of Region 4. Inhabitants of Region 4 had also higher levels of C reactive protein (Region 1: 4.56 ± 4.85 mg/l; Region 2: 3.49 ± 4.46 mg/l; Region 3: 4.03 ± 3.32 mg/l, Region 4: 5.16 ± 8.26 mg/l, p < 0.001). Propensity score analysis revealed higher inter-area differences in mean cIMT of individuals with coronary artery disease (CAD) (high vs low air pollution area: 1.56 ± 0.80 mm; vs. 1.18 ± 0.54 mm, p < 0.001) while there was no difference in cIMT of the matched population without CAD ( p = 0.52). Conclusions: An increased carotid atherosclerotic and inflammatory burden is observed in inhabitants of areas with the highest concentration of air pollutants. Highlights: Environmental factors have been implicated in various disease processes. Air pollution is an environmental factor contributing significantly to cardiovascular disease burden. Our study highlights the hazardous effect of poor air quality on carotid atherosclerosis. Air pollution's effect on carotid atherosclerosis is more pronounced in individuals with coronary artery disease.