BACKGROUND: Environmental pollution and weather changes unfavorably impact on cardiovascular disease. However, limited research has focused on ST-elevation myocardial infarction (STEMI), the most severe yet distinctive form of acute coronary syndrome. METHODS AND RESULTS: We appraised the impact of environmental and weather changes on the incidence of STEMI, analysing the bivariate and multivariable association between several environmental and atmospheric parameters and the daily incidence of STEMI in two large Italian urban areas. Specifically, we appraised: carbon monoxide (CO), nitrogen dioxide (NO2), nitric oxide (NOX), ozone, particulate matter smaller than 10 μm (PM10) and than 2.5 μm (PM2.5), temperature, atmospheric pressure, humidity and rainfall. A total of 4285 days at risk were appraised, with 3473 cases of STEMI. Specifically, no STEMI occurred in 1920 (44.8%) days, whereas one or more occurred in the remaining 2365 (55.2%) days. Multilevel modelling identified several pollution and weather predictors of STEMI. In particular, concentrations of CO (p = 0.024), NOX (p = 0.039), ozone (p = 0.003), PM10 (p = 0.033) and PM2.5 (p = 0.042) predicted STEMI as early as three days before the event, as well as subsequently, and NO predicted STEMI one day before (p = 0.010), as well as on the same day. A similar predictive role was evident for temperature and atmospheric pressure (all p < 0.05). CONCLUSIONS: The risk of STEMI is strongly associated with pollution and weather features. While causation cannot yet be proven, environmental and weather changes could be exploited to predict STEMI risk in the following days. Published on behalf of the European Society of Cardiology. All rights reserved.
BACKGROUND: Environmental pollution and weather changes unfavorably impact on cardiovascular disease. However, limited research has focused on ST-elevation myocardial infarction (STEMI), the most severe yet distinctive form of acute coronary syndrome. METHODS AND RESULTS: We appraised the impact of environmental and weather changes on the incidence of STEMI, analysing the bivariate and multivariable association between several environmental and atmospheric parameters and the daily incidence of STEMI in two large Italian urban areas. Specifically, we appraised: carbon monoxide (CO), nitrogen dioxide (NO2), nitric oxide (NOX), ozone, particulate matter smaller than 10 μm (PM10) and than 2.5 μm (PM2.5), temperature, atmospheric pressure, humidity and rainfall. A total of 4285 days at risk were appraised, with 3473 cases of STEMI. Specifically, no STEMI occurred in 1920 (44.8%) days, whereas one or more occurred in the remaining 2365 (55.2%) days. Multilevel modelling identified several pollution and weather predictors of STEMI. In particular, concentrations of CO (p = 0.024), NOX (p = 0.039), ozone (p = 0.003), PM10 (p = 0.033) and PM2.5 (p = 0.042) predicted STEMI as early as three days before the event, as well as subsequently, and NO predicted STEMI one day before (p = 0.010), as well as on the same day. A similar predictive role was evident for temperature and atmospheric pressure (all p < 0.05). CONCLUSIONS: The risk of STEMI is strongly associated with pollution and weather features. While causation cannot yet be proven, environmental and weather changes could be exploited to predict STEMI risk in the following days. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Eugenio Picano; Quirino Ciampi; Lauro Cortigiani; Adelaide M Arruda-Olson; Clarissa Borguezan-Daros; José Luis de Castro E Silva Pretto; Rosangela Cocchia; Eduardo Bossone; Elisa Merli; Garvan C Kane; Albert Varga; Gergely Agoston; Maria Chiara Scali; Doralisa Morrone; Iana Simova; Martina Samardjieva; Alla Boshchenko; Tamara Ryabova; Alexander Vrublevsky; Attila Palinkas; Eszter D Palinkas; Robert Sepp; Marco A R Torres; Hector R Villarraga; Tamara Kovačević Preradović; Rodolfo Citro; Miguel Amor; Hugo Mosto; Michael Salamè; Paul Leeson; Cristina Mangia; Nicola Gaibazzi; Domenico Tuttolomondo; Costantina Prota; Jesus Peteiro; Caroline M Van De Heyning; Antonello D'Andrea; Fausto Rigo; Aleksandra Nikolic; Miodrag Ostojic; Jorge Lowenstein; Rosina Arbucci; Diego M Lowenstein Haber; Pablo M Merlo; Karina Wierzbowska-Drabik; Jaroslaw D Kasprzak; Maciej Haberka; Ana Cristina Camarozano; Nithima Ratanasit; Fabio Mori; Maria Grazia D'Alfonso; Luigi Tassetti; Alessandra Milazzo; Iacopo Olivotto; Alberto Marchi; Hugo Rodriguez-Zanella; Angela Zagatina; Ratnasari Padang; Milica Dekleva; Ana Djordievic-Dikic; Nikola Boskovic; Milorad Tesic; Vojislav Giga; Branko Beleslin; Giovanni Di Salvo; Valentina Lorenzoni; Matteo Cameli; Giulia Elena Mandoli; Tonino Bombardini; Pio Caso; Jelena Celutkiene; Andrea Barbieri; Giovanni Benfari; Ylenia Bartolacelli; Alessandro Malagoli; Francesca Bursi; Francesca Mantovani; Bruno Villari; Antonello Russo; Michele De Nes; Clara Carpeggiani; Ines Monte; Federica Re; Carlos Cotrim; Giuseppe Bilardo; Ariel K Saad; Arnas Karuzas; Dovydas Matuliauskas; Paolo Colonna; Francesco Antonini-Canterin; Mauro Pepi; Patricia A Pellikka Journal: J Clin Med Date: 2021-08-17 Impact factor: 4.964