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

OBJECTIVE

Air pollution contributes to cardiovascular diseases through oxidative stress, inflammation, autonomic nervous system imbalance, and direct particle translocation. This study examines the relationship between air pollution parameters and risk factors in patients presenting with ST-elevation myocardial infarction (STEMI).

METHODS

This prospective, cross-sectional study included STEMI patients aged at least 18 years in a tertiary 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 younger patients [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 AQI and PM2.5 levels exceed EPA limits, they may interact with cardiovascular risk factors such as age, sex, and comorbidities, contributing to the development of STEMI. Elderly individuals, women, and those with a history of cardiovascular disease may be more susceptible to the adverse effects of air pollution.