Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Italy.
Mediterranea Cardiocentro, Italy.
Eur J Prev Cardiol. 2021 Oct 25;28(13):1501-1507. doi: 10.1177/2047487320928450. Epub 2020 Jun 2.
Environmental pollution and weather changes unfavorably impact on cardiovascular disease. However, limited research has focused on ST-elevation myocardial infarction (STEMI), the most severe yet distinctive form of acute coronary syndrome.
We appraised the impact of environmental and weather changes on the incidence of STEMI, analysing the bivariate and multivariable association between several environmental and atmospheric parameters and the daily incidence of STEMI in two large Italian urban areas. Specifically, we appraised: carbon monoxide (CO), nitrogen dioxide (NO2), nitric oxide (NOX), ozone, particulate matter smaller than 10 μm (PM10) and than 2.5 μm (PM2.5), temperature, atmospheric pressure, humidity and rainfall. A total of 4285 days at risk were appraised, with 3473 cases of STEMI. Specifically, no STEMI occurred in 1920 (44.8%) days, whereas one or more occurred in the remaining 2365 (55.2%) days. Multilevel modelling identified several pollution and weather predictors of STEMI. In particular, concentrations of CO (p = 0.024), NOX (p = 0.039), ozone (p = 0.003), PM10 (p = 0.033) and PM2.5 (p = 0.042) predicted STEMI as early as three days before the event, as well as subsequently, and NO predicted STEMI one day before (p = 0.010), as well as on the same day. A similar predictive role was evident for temperature and atmospheric pressure (all p < 0.05).
The risk of STEMI is strongly associated with pollution and weather features. While causation cannot yet be proven, environmental and weather changes could be exploited to predict STEMI risk in the following days.
环境污染和气候变化对心血管疾病有不利影响。然而，针对 ST 段抬高型心肌梗死（STEMI）这一最严重但又具有独特性的急性冠脉综合征形式的研究却很有限。
我们评估了环境和天气变化对 STEMI 发病率的影响，分析了两个意大利大城市中几种环境和大气参数与 STEMI 日发病率之间的双变量和多变量关联。具体来说，我们评估了一氧化碳（CO）、二氧化氮（NO2）、氮氧化物（NOX）、臭氧、小于 10μm（PM10）和小于 2.5μm（PM2.5）的颗粒物、温度、大气压、湿度和降雨量。评估了共 4285 天的风险期，其中有 3473 例 STEMI 病例。具体来说，1920 天（44.8%）没有 STEMI 发生，而其余 2365 天（55.2%）发生了一例或多例 STEMI。多水平模型确定了几个 STEMI 的污染和天气预测因子。特别是，CO（p=0.024）、NOX（p=0.039）、臭氧（p=0.003）、PM10（p=0.033）和 PM2.5（p=0.042）浓度早在事件发生前三天就预测了 STEMI，随后也预测了 STEMI，而 NO 则在事件发生前一天（p=0.010）和当天预测了 STEMI。温度和大气压也具有类似的预测作用（均 p<0.05）。
STEMI 的风险与污染和天气特征密切相关。虽然还不能证明因果关系，但环境和天气变化可以用来预测未来几天的 STEMI 风险。
