TY - JOUR
T1 - L'exposition aux polluants atmosphériques à terme court comme facteurs de risque des syndromes coronariens aigus dans les zones urbaines aux taux de pollution annuels bas
T2 - résultats d'une étude rétrospective
AU - Gestro, Massimo
AU - Condemi, Vincenzo
AU - Bardi, Luisella
AU - Tomaino, Laura
AU - Roveda, Eliana
AU - Bruschetta, Antongiulio
AU - Solimene, Umberto
AU - Esposito, Fabio
N1 - Funding Information:
The authors wish to thank the S. Croce and Carle Hospital of Cuneo for the data, as well as Dr Pamela Pogliani and Mr Mauro Giraudo for their valuable support throughout the research. M. G. supervised and synthesized all the clinical data analyses, and led the writing. V. C. originated and supervised all aspects of the study, especially statistical methodology. L. B. and L. T. were involved in all environmental aspects of the study. E. R. A. B. U. S. and F. E. led the literature review and supervised aspects related to clinical issues. All the authors participated in reviewing and drafting the manuscript.
Publisher Copyright:
© 2020 Elsevier Masson SAS
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/5
Y1 - 2020/5
N2 - Background: Epidemiological data suggest that air pollutants are risk factors for cardiovascular disease. Recent studies have questioned the adequacy of current legal pollutant limits, because concentrations lower than those recommended still affect cardiovascular morbidity and mortality. Aim: To investigate the association between short-term exposure to air pollutants and the daily diagnosis of acute coronary syndrome (ACS) at the emergency department (ED) of S. Croce Hospital (Cuneo, Italy), between 2011 and 2015. Methods: We evaluated the effect of particulate matter (PM2.5–10), nitrogen dioxide and ozone as primary exposure, together with temperature and relative humidity as climatological control variables, on ED admissions for ACS (response variables). We studied residents aged ≥ 35 years, classified into three age groups (35–64, 65–74 and ≥ 75 years). Environmental data were analysed according to Poisson's regression, and conventional cardiovascular risk factors (CRFs; hypertension, diabetes, coronary artery disease, smoking and dyslipidaemia) were included as control variables. Results: ED admissions for ACS were 1625/391,689, with 298 in 2011 (0.183%), 305 in 2012 (0.188%), 347 in 2013 (0.214%), 341 in 2014 (0.21%) and 334 in 2015 (0.206%), with a general growth rate of 2.08% (from 2011 to 2015). The CRFs examined were confirmed to be highly associated with occurrence of ACS. Our study identified PM2.5 and temperature in all age groups to be additional risk factors, with PM2.5 exposure (P < 0.01) being a particular risk for those aged ≥ 75 years. Dose-response models confirmed only PM2.5 as the main environmental risk factor in elderly patients (relative risk 1.06, 95% confidence interval 1.02–1.11; lag time 0–3 days). We also found a consistent relative risk for temperature in all age groups. Conclusion: This study confirms the importance of PM2.5 as a risk factor for ACS, mostly in elderly patients, even in a city with low annual pollution rates.
AB - Background: Epidemiological data suggest that air pollutants are risk factors for cardiovascular disease. Recent studies have questioned the adequacy of current legal pollutant limits, because concentrations lower than those recommended still affect cardiovascular morbidity and mortality. Aim: To investigate the association between short-term exposure to air pollutants and the daily diagnosis of acute coronary syndrome (ACS) at the emergency department (ED) of S. Croce Hospital (Cuneo, Italy), between 2011 and 2015. Methods: We evaluated the effect of particulate matter (PM2.5–10), nitrogen dioxide and ozone as primary exposure, together with temperature and relative humidity as climatological control variables, on ED admissions for ACS (response variables). We studied residents aged ≥ 35 years, classified into three age groups (35–64, 65–74 and ≥ 75 years). Environmental data were analysed according to Poisson's regression, and conventional cardiovascular risk factors (CRFs; hypertension, diabetes, coronary artery disease, smoking and dyslipidaemia) were included as control variables. Results: ED admissions for ACS were 1625/391,689, with 298 in 2011 (0.183%), 305 in 2012 (0.188%), 347 in 2013 (0.214%), 341 in 2014 (0.21%) and 334 in 2015 (0.206%), with a general growth rate of 2.08% (from 2011 to 2015). The CRFs examined were confirmed to be highly associated with occurrence of ACS. Our study identified PM2.5 and temperature in all age groups to be additional risk factors, with PM2.5 exposure (P < 0.01) being a particular risk for those aged ≥ 75 years. Dose-response models confirmed only PM2.5 as the main environmental risk factor in elderly patients (relative risk 1.06, 95% confidence interval 1.02–1.11; lag time 0–3 days). We also found a consistent relative risk for temperature in all age groups. Conclusion: This study confirms the importance of PM2.5 as a risk factor for ACS, mostly in elderly patients, even in a city with low annual pollution rates.
KW - Acute coronary syndrome
KW - Air pollution
KW - Epidemiology
KW - Prevention
KW - Risk factors
UR - http://www.scopus.com/inward/record.url?scp=85083892998&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85083892998&partnerID=8YFLogxK
U2 - 10.1016/j.acvd.2020.03.013
DO - 10.1016/j.acvd.2020.03.013
M3 - Articolo
C2 - 32359859
AN - SCOPUS:85083892998
VL - 113
SP - 308
EP - 320
JO - Archives of Cardiovascular Diseases
JF - Archives of Cardiovascular Diseases
SN - 1875-2136
IS - 5
ER -