Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Clin Cardiol. 2023 Nov;46(11):1319-1325. doi: 10.1002/clc.24111. Epub 2023 Aug 4.
Previous studies evaluated the impact of particle matters (PM) on the risk of acute myocardial infarction (AMI) based on local registries.
This study aimed to evaluate possible short term effect of air pollutants on occurrence of AMI based on a specific case report sheet that was designed for this purpose.
AMI was documented among 982 patients who referred to the emergency departments in Tehran, Iran, between July 2017 to March 2019. For each patient, case period was defined as 24 hour period preceding the time of emergency admission and referent periods were defined as the corresponding time in 1, 2, and 3 weeks before the admission. The associations of particulate matter with an aerodynamic diameter ≤2.5 μm (PM ) and particulate matter with an aerodynamic diameter ≤10 μm (PM ) with AMI were analyzed using conditional logistic regression in a case-crossover design.
Increase in PM and PM was significantly associated with the occurrence of AMI with and without adjustment for the temperature and humidity. In the adjusted model each 10 μg/m increase of PM and PM in case periods was significantly associated with increase myocardial infarction events (95% CI = 1.041-1.099, OR = 1.069 and 95% CI = 1.073-1.196, and OR = 1.133, respectively). Subgroup analysis showed that increase in PM did not increase AMI events in diabetic subgroup, but in all other subgroups PM and PM concentration showed positive associations with increased AMI events.
Acute exposure to ambient air pollution was associated with increased risk of AMI irrespective of temperature and humidity.
先前的研究基于当地登记处评估了颗粒物（PM）对急性心肌梗死（AMI）风险的影响。
本研究旨在根据为此目的设计的特定病例报告表评估空气污染物对 AMI 发生的可能短期影响。
2017 年 7 月至 2019 年 3 月期间，伊朗德黑兰的急诊科共收治了 982 例 AMI 患者。对于每位患者，病例期定义为急诊入院前 24 小时，参照期定义为入院前 1、2 和 3 周的相应时间。采用条件逻辑回归病例交叉设计分析了空气动力学直径≤2.5μm 的颗粒物（PM ）和空气动力学直径≤10μm 的颗粒物（PM ）与 AMI 的关联。
调整温度和湿度后，PM 和 PM 的增加与 AMI 的发生呈显著相关。在调整后的模型中，病例期每增加 10μg/m 的 PM 和 PM ，心肌梗死事件的发生率显著增加（95%CI=1.041-1.099，OR=1.069；95%CI=1.073-1.196，OR=1.133）。亚组分析显示，在糖尿病亚组中，PM 的增加并未增加 AMI 事件，但在其他所有亚组中，PM 和 PM 的浓度与 AMI 事件的增加呈正相关。
急性暴露于环境空气污染与 AMI 风险增加有关，与温度和湿度无关。
