ST-elevation myocardial infarction and air pollution: relationship between hourly air pollution and cardiovascular risk factors

ST-elevation myocardial infarction and air pollution: relationship between hourly air pollution and cardiovascular risk factors
J Cardiovasc Med (Hagerstown). 2025 Aug 1;26(8):412-419.

Abstract

Objective: Air pollution contributes to cardiovascular diseases through oxidative stress, inflammation, autonomicnervous system imbalance, and direct particle translocation. This study examines the relationship between air pollution parameters and risk factors in patients presenting with (STEMI).

Methods: This prospective, cross-sectional studyincluded ST-elevation myocardial infarction patients aged at least 18 years in a tertiary ST-elevation myocardial infarction hospital. Demographics, comorbidities, seasonal variations, comorbidities, vital signs, hourly air pollution and weather parameters on admission, hospital length of stay, treatment modalities, and outcomes were recorded.

Results: Among 1413 patients, 75.1% were men. The median age of female patients [65 (IQR: 58-73)] was significantly higher that of than males [55 (IQR: 50-66), P < 0.001].Median air quality index (AQI) [53 (IQR: 37-55)] and particulate matter (PM2.5) levels [18 (IQR: 11-27)] on admission were above Environmental Protection Agency limits. Patients with prior coronary artery disease (P = 0.037)and female patients (P = 0.018) had significantly lower PM10 exposure. PM2.5 levels were significantly higher in patients aged >75 years [20.5 (IQR: 13-29)] than in youngerpatients [18 (IQR: 11-27), P = 0.022]. Those recommended for coronary artery bypass grafting had lower sulfur dioxide levels [6 (IQR: 4-9) vs. 8 (IQR: 5-13), P = 0.003].

Conclusion: When air quality index and particulatematter 2.5 levels exceed EPA limits, they may interact with cardiovascular risk factors such as age, sex, and comorbidities, contributing to the development ofST-elevation myocardial infarction. Elderly individuals, women, and those with a history of cardiovascular disease may be more susceptible to the adverse effects of air pollution.

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