title: Air pollution and short-term clinical outcomes of patients with acute myocardial infarction.
abstract: 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, O3and 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 NO2concentration, 0.001 ppm increase in SO2concentration, 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, O3decreased the risk of total death by 0.6% (95% CI -0.2% to -1.0%) per 0.01 ppm increase. PM10was 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 NO2were positively associated with total death, cardiac death and MI, while SO2, CO, O3and PM10were 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.
authors.affiliation: Department of Integrated Biomedical and Life Sciences, Korea University Graduate School, Seoul, Korea.
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Lee
authors.affiliation: Department of Medicine, Korea University Graduate School, Seoul, Korea.
authors.forename: Byoung Geol
authors.initials: BG
authors.lastname: Choi
authors.affiliation: Department of Integrated Biomedical and Life Sciences, Korea University Graduate School, Seoul, Korea.
authors.forename: Suhng Wook
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Medicine, Korea University Graduate School, Seoul, Korea.|Korea University Guro Hospital, Seoul, Korea.
authors.forename: Seung-Woon
authors.identifier: http://orcid.org/0000-0001-9456-9852
authors.initials: SW
authors.lastname: Rha
authors.affiliation: Korea University Guro Hospital, Seoul, Korea.
authors.forename: Min Suk
authors.initials: MS
authors.lastname: Shim
authors.affiliation: Department of Integrated Biomedical and Life Sciences, Korea University Graduate School, Seoul, Korea.
authors.forename: Dae Jin
authors.initials: DJ
authors.lastname: Kim
authors.affiliation: Korea University Guro Hospital, Seoul, Korea.
authors.forename: Hong Seog
authors.initials: HS
authors.lastname: Seo
authors.affiliation: Korea University Guro Hospital, Seoul, Korea.
authors.forename: Dong Joo
authors.initials: DJ
authors.lastname: Oh
authors.affiliation: Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000393:Air Pollutants / Q000009:adverse effects; D000397:Air Pollution / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology* / Q000628:therapy; D011379:Prognosis; D012306:Risk; D013997:Time Factors
chemical_list: D000393:Air Pollutants
keywords: Acute myocardial infarction; air pollutant; air pollution; particular matter