BACKGROUND: Long-term air pollution exposure is associated with increased mortality, but the association with incidence of fatal and nonfatal coronary heart disease is less certain. Moreover, it is unknown how chronic exposure to air pollution affects prognosis among survivors of a first coronary event. This study evaluated the association between long-term traffic-related air pollution exposure and incidence of nonfatal and fatal coronary events, as well as subsequent hospital readmission and mortality among myocardial infarction survivors. METHODS: The study population comprised all residents of Rome aged 35-84 years during the period 1998-2000. Residential nitrogen dioxide (NO2) exposure as a marker of traffic pollution was assessed by a land-use regression model in 1995-1996 (R = 0.69). A total of 11,167 incident coronary events were observed (4654 fatal, including 3598 out-of-hospital coronary deaths, and 6513 nonfatal). The cohort of 6513 survivors was followed 4.0-7.5 years for readmission or mortality, starting 28 days from the date of first event. Relative risks per 10 mug/m of NO2 exposure, adjusted for age, sex, and socioeconomic status, were calculated by Poisson regression (population-based incidence) and Cox regression (cohort analysis). RESULTS: The relative risk for incidence in coronary events per 10 mug/m of NO2 was 1.03 (95% confidence interval = 1.00-1.07). Stronger associations were found for fatal cases (1.07; 1.02-1.12) and out-of-hospital deaths (1.08; 1.02-1.13). Using NO2 exposure at the time of the first event, there was no association of air pollution exposure with either subsequent hospital readmission or mortality among survivors of the first coronary event. CONCLUSIONS: Long-term air pollution exposure increases the risk of coronary heart disease, particularly fatal events. Hospital readmission or subsequent mortality among survivors was not associated with traffic air pollution.
BACKGROUND: Long-term air pollution exposure is associated with increased mortality, but the association with incidence of fatal and nonfatal coronary heart disease is less certain. Moreover, it is unknown how chronic exposure to air pollution affects prognosis among survivors of a first coronary event. This study evaluated the association between long-term traffic-related air pollution exposure and incidence of nonfatal and fatal coronary events, as well as subsequent hospital readmission and mortality among myocardial infarction survivors. METHODS: The study population comprised all residents of Rome aged 35-84 years during the period 1998-2000. Residential nitrogen dioxide (NO2) exposure as a marker of traffic pollution was assessed by a land-use regression model in 1995-1996 (R = 0.69). A total of 11,167 incident coronary events were observed (4654 fatal, including 3598 out-of-hospital coronary deaths, and 6513 nonfatal). The cohort of 6513 survivors was followed 4.0-7.5 years for readmission or mortality, starting 28 days from the date of first event. Relative risks per 10 mug/m of NO2 exposure, adjusted for age, sex, and socioeconomic status, were calculated by Poisson regression (population-based incidence) and Cox regression (cohort analysis). RESULTS: The relative risk for incidence in coronary events per 10 mug/m of NO2 was 1.03 (95% confidence interval = 1.00-1.07). Stronger associations were found for fatal cases (1.07; 1.02-1.12) and out-of-hospital deaths (1.08; 1.02-1.13). Using NO2 exposure at the time of the first event, there was no association of air pollution exposure with either subsequent hospital readmission or mortality among survivors of the first coronary event. CONCLUSIONS: Long-term air pollution exposure increases the risk of coronary heart disease, particularly fatal events. Hospital readmission or subsequent mortality among survivors was not associated with traffic air pollution.
Authors: Iny Jhun; Jina Kim; Bennet Cho; Diane R Gold; Joel Schwartz; Brent A Coull; Antonella Zanobetti; Mary B Rice; Murray A Mittleman; Eric Garshick; Pantel Vokonas; Marie-Abele Bind; Elissa H Wilker; Francesca Dominici; Helen Suh; Petros Koutrakis Journal: J Air Waste Manag Assoc Date: 2019-08 Impact factor: 2.235
Authors: Iain M Carey; Richard W Atkinson; Andrew J Kent; Tjeerd van Staa; Derek G Cook; H Ross Anderson Journal: Am J Respir Crit Care Med Date: 2013-06-01 Impact factor: 21.405
Authors: Niklas Berglind; Petter Ljungman; Jette Möller; Johan Hallqvist; Fredrik Nyberg; Mårten Rosenqvist; Göran Pershagen; Tom Bellander Journal: Int J Environ Res Public Health Date: 2010-03-31 Impact factor: 3.390
Authors: Antonella Zanobetti; Peter H Stone; Frank E Speizer; Joel D Schwartz; Brent A Coull; Helen H Suh; Bruce D Nearing; Murray A Mittleman; Richard L Verrier; Diane R Gold Journal: Am J Cardiol Date: 2009-06-24 Impact factor: 2.778
Authors: Zhengmin Qian; Hung-Mo Lin; Vernon M Chinchilli; Erik B Lehman; Walter F Stewart; Nirav Shah; Yinkang Duan; Timothy J Craig; William E Wilson; Duanping Liao; Stephen C Lazarus; Rebecca Bascom Journal: J Toxicol Environ Health A Date: 2009
Authors: C Tonne; J Yanosky; A Gryparis; S Melly; M Mittleman; R Goldberg; S von Klot; J Schwartz Journal: Occup Environ Med Date: 2009-06-23 Impact factor: 4.402