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Long-term effects of air quality on hospital readmission for heart failure in patients with acute myocardial infarction.
Zhang, Lingling; Liu, Zhican; Zeng, Jianping; Wu, Mingxin.
Afiliação
  • Zhang L; Department of Cardiology, Xiangtan Central Hospital, Xiangtan 411100, China; Chest Pain Centre, Xiangtan Central Hospital, Xiangtan 411100, China; Department of Scientific Research, Xiangtan Central Hospital, Xiangtan 411100, China. Electronic address: linglingzhang0217@163.com.
  • Liu Z; Department of Cardiology, Xiangtan Central Hospital, Xiangtan 411100, China; Department of Pulmonary and Critical Care Medicine, Xiangtan Central Hospital, Xiangtan 411100, China; Department of Scientific Research, Xiangtan Central Hospital, Xiangtan 411100, China. Electronic address: liuzhican@mail
  • Zeng J; Department of Cardiology, Xiangtan Central Hospital, Xiangtan 411100, China; Chest Pain Centre, Xiangtan Central Hospital, Xiangtan 411100, China; Department of Scientific Research, Xiangtan Central Hospital, Xiangtan 411100, China. Electronic address: zengjianping@mail.chzu.edu.cn.
  • Wu M; Department of Cardiology, Xiangtan Central Hospital, Xiangtan 411100, China; Chest Pain Centre, Xiangtan Central Hospital, Xiangtan 411100, China; Department of Scientific Research, Xiangtan Central Hospital, Xiangtan 411100, China; Graduate Collaborative Training Base of Xiangtan Central Hospital,
Int J Cardiol ; 412: 132344, 2024 Oct 01.
Article em En | MEDLINE | ID: mdl-38977226
ABSTRACT

BACKGROUND:

Cardiovascular disease (CVD) is the leading cause of death worldwide, with air pollution posing significant risks to cardiovascular health. The effect of air quality on heart failure (HF) readmission in acute myocardial infarction (AMI) patients is unclear.The aim of this study was to evaluate the role of a single measure of air pollution exposure collected on the day of first hospitalization.

METHODS:

We retrospectively analyzed data from 12,857 acute coronary syndrome (ACS) patients (January 2015-March 2023). After multiple screenings, 4023 AMI patients were included. The air pollution data is updated by the automatic monitoring data of the national urban air quality monitoring stations in real time and synchronized to the China Environmental Monitoring Station. Cox proportional hazards regression assessed the impact of air quality indicators on admission and outcomes in 4013 AMI patients. A decision tree model identified the most susceptible groups.

RESULTS:

After adjusting for confounders, NO2 (HR 1.009, 95% CI 1.004-1.015, P = 0.00066) and PM10 (HR 1.006, 95% CI 1.002-1.011, P = 0.00751) increased the risk of HF readmission in ST-segment elevation myocardial infarction (STEMI) patients. No significant effect was observed in non-STEMI (NSTEMI) patients (P > 0.05). STEMI patients had a 2.8-fold higher risk of HF readmission with NO2 > 13 µg/m3 (HR 2.857, 95% CI 1.439-5.670, P = 0.00269) and a 1.65-fold higher risk with PM10 > 55 µg/m3 (HR 1.654, 95% CI 1.124-2.434, P = 0.01064).

CONCLUSION:

NO2 and PM10 are linked to increased HF readmission risk in STEMI patients, particularly when NO2 exceeds 13 µg/m3 and PM10 exceeds 55 µg/m3. Younger, less symptomatic male STEMI patients with fewer underlying conditions are more vulnerable to these pollutants.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Readmissão do Paciente / Poluição do Ar / Insuficiência Cardíaca / Infarto do Miocárdio Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Int J Cardiol Ano de publicação: 2024 Tipo de documento: Article País de publicação: Holanda

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Readmissão do Paciente / Poluição do Ar / Insuficiência Cardíaca / Infarto do Miocárdio Limite: Aged / Female / Humans / Male / Middle aged País/Região como assunto: Asia Idioma: En Revista: Int J Cardiol Ano de publicação: 2024 Tipo de documento: Article País de publicação: Holanda