Particulate¹ matter and NO2 air pollution are associated with increased risk of severe heart attacks despite being within European recommended levels, according to research presented at ESC Congress today by Dr Jean-Francois Argacha, a cardiologist at University Hospital Brussels (UZ Brussel-Vrije Universiteit Brussel), in Belgium.1 "Dramatic health consequences of air pollution were first described in Belgium in 1930 after the Meuse Valley fog," said Dr Argacha. "Nowadays, the World Health Organization (WHO) considers air pollution as one of the largest avoidable causes of mortality. Besides the pulmonary and carcinogenic effects of air pollution, exposition to air pollution has been associated with an increased risk in cardiovascular mortality."

 

"In addition to the long term consequences, more recent research suggests that acute exposure to air pollution may trigger some cardiovascular events such as strokes, heart failure or myocardial infarction (heart attack)," continued Dr Argacha. "Myocardial infarction covers a number of clinical conditions and the effect of pollution on these subsets is unknown."

 

The current study investigated the effect of short term exposure to air pollution on the risk of ST-segment elevation² myocardial infarction (STEMI). This type of myocardial infarction has the worst prognosis and is caused by thrombotic occlusion of a coronary artery³ that damages the heart.

 

Ambient air pollution is a mixture of particulate matter (PM) and gaseous⁴ pollutants⁵ such as sulfur⁶ dioxide (SO2), nitric dioxide (NO2) and ozone⁷ (O3). Fine particle pollution, also called PM2.5, has the ability to reach the lower respiratory tract⁸ and carry a large amount of toxic⁹ compound into the body. PM2.5 and NO2 originate predominantly from the combustion¹⁰ of fossil fuels such as emissions¹¹ from industrial plants or vehicles.

 

Data on PM10, PM2.5, O3 and NO2 levels were obtained from Belgian Environmental Agency air pollution records. A statistical¹² model called RIO was used to provide a real-time evaluation¹³ of air pollution exposure in each part of Belgium with adjustments for population density¹⁴. Data on STEMI incidence came from the Belgian Interdisciplinary Working Group on Acute Cardiology (BIWAC) STEMI registry, using STEMI hospitalisation as a proxy¹⁵ indicator¹⁶. The relationship between pollutants and STEMI was assessed using a case-crossover design and performed by the biostatistics department of Université Libre de Bruxelles (ULB), Brussels, Belgium.

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