Medical Department, Xiangtan Central Hospital, The Affiliated Hospital of Hunan University, Xiangtan, 411100, China.
Cardiologist of Medical Department, Xiangtan Central Hospital, Xiangtan, 411100, China.
Sci Rep. 2024 Sep 27;14(1):22132. doi: 10.1038/s41598-024-73495-5.
Cardiovascular disease remains the leading cause of death worldwide, with air pollution's impact on cardiovascular health being closely monitored. However, the specific effects of air pollution on the risk of hospital readmission for heart failure (HF) in patients with unstable angina (UA) have not been fully explored. We conducted a retrospective study involving 12,857 consecutive patients diagnosed with acute coronary syndrome (ACS) between January 2015 and March 2023. After rigorous screening, we included 8,737 patients with UA in the analysis. Furthermore, we used a Cox proportional hazards regression model to examine the relationship between air quality indicators and hospital readmission for HF in patients with UA. Additionally, a decision tree model identified air quality indicators levels that had the most significant impact on readmission for HF risk. After adjusting for confounding factors, we found that elevated levels of PM10 [hazard ratio (HR) = 1.003, 95% confidence interval (CI): 1.000-1.005, p = 0.04453] and CO (HR = 1.013, 95% CI: 1.005-1.021, p = 0.00216) were associated with an increased risk of hospital readmission for HF in UA patients. Specifically, patients exposed to PM10 levels above 112.5 µ g/m had a 1.61-fold higher risk of readmission for HF in UA patients. (HR = 1.609, 95% CI: 1.190-2.176, p = 0.00201), and those exposed to CO levels above 37.5 mg/m had a 2.70-fold higher risk of readmission for HF in UA patients. (HR = 2.681, 95% CI: 1.731-4.152, p < 0.00001). Higher concentrations of PM10 and CO significantly increased the risk of HF (HF) readmission in patients with UA after discharge, particularly when PM10 levels exceeded 112.5 ug/m and CO levels surpassed 37.5 ug/m. Besides, female patients with UA, with fewer underlying diseases, were more susceptible to the adverse effects of PM10 and CO.
心血管疾病仍然是全球死亡的主要原因，空气污染对心血管健康的影响受到密切监测。然而，空气污染对不稳定型心绞痛（UA）患者心力衰竭（HF）住院再入院风险的具体影响尚未得到充分探讨。我们进行了一项回顾性研究，纳入了 2015 年 1 月至 2023 年 3 月期间被诊断为急性冠状动脉综合征（ACS）的 12857 例连续患者。经过严格筛选，我们纳入了 8737 例 UA 患者进行分析。此外，我们使用 Cox 比例风险回归模型研究了空气质量指标与 UA 患者 HF 住院再入院之间的关系。此外，决策树模型确定了对 HF 再入院风险影响最大的空气质量指标水平。在调整混杂因素后，我们发现 PM10 水平升高[风险比（HR）=1.003，95%置信区间（CI）：1.000-1.005，p=0.04453]和 CO（HR=1.013，95%CI：1.005-1.021，p=0.00216）与 UA 患者 HF 住院再入院风险增加相关。具体而言，暴露于 PM10 水平高于 112.5 µg/m 的患者 UA 患者 HF 再入院的风险增加 1.61 倍。（HR=1.609，95%CI：1.190-2.176，p=0.00201），暴露于 CO 水平高于 37.5 mg/m 的患者 UA 患者 HF 再入院的风险增加 2.70 倍。（HR=2.681，95%CI：1.731-4.152，p<0.00001）。PM10 和 CO 浓度升高显著增加了 UA 患者出院后 HF（HF）再入院的风险，尤其是当 PM10 水平超过 112.5 ug/m 且 CO 水平超过 37.5 ug/m 时。此外，UA 女性患者基础疾病较少，更容易受到 PM10 和 CO 的不良影响。
