Journal of the American Heart Association · 2026
Case-Crossover Analysis of Short-Term Particulate Matter and Health Outcomes in Patients With Atrial Fibrillation.
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Yang Lanting, Gabriel Nico, Tang Shangbin, Cater Lauren, Blackburn Hayley, Page Robert L, Saba Samir, Hernandez Inmaculada
Аннотация
BACKGROUND: Residents of western US states face elevated fine particulate matter (PM2.5) exposure from increasingly frequent and intense wildfires, raising concerns about cardiovascular risk. Whether short-term PM2.5 exposure increases odds of hospitalization or emergency care in patients with established atrial fibrillation (AF) remains unclear.
METHODS: Using 2021 Medicare data, we identified patients with established AF residing in western US states. Zip code-level daily PM2.5 was estimated using a 1 km2 geospatial model; high PM2.5 was defined as ≥9.0 μg/m3. Odds ratios (ORs) for all-cause and cardiovascular disease hospitalization and emergency department visits were estimated using conditional logistic regression at lag 0, 1, and 3 days, adjusting for extreme heat and public holidays.
RESULTS: The final cohort included 26 158 patients (mean age 79 ± 9.0 years) with established AF. Exposure to high levels of PM2.5 was associated with 10% (95% CI, 1%-20%) increased odds of hospitalizations for cardiovascular disease. Specifically, high PM2.5 was associated with 24% (95% CI, 3%-48%) increased odds of hospitalization and 34% (95% CI, 6%-70%) higher odds of emergency department visits for all AF-related diagnoses. We did not observe significant interaction effects between PM2.5 and extreme heat on the risk of hospitalization or emergency department visits for cardiovascular disease or AF.
CONCLUSION: On days with elevated PM2.5 levels, patients with AF were associated with higher odds of AF-related or cardiovascular hospitalizations and emergency department visits, highlighting the need for targeted prevention strategies to protect vulnerable populations from the adverse effects of air pollution.
METHODS: Using 2021 Medicare data, we identified patients with established AF residing in western US states. Zip code-level daily PM2.5 was estimated using a 1 km2 geospatial model; high PM2.5 was defined as ≥9.0 μg/m3. Odds ratios (ORs) for all-cause and cardiovascular disease hospitalization and emergency department visits were estimated using conditional logistic regression at lag 0, 1, and 3 days, adjusting for extreme heat and public holidays.
RESULTS: The final cohort included 26 158 patients (mean age 79 ± 9.0 years) with established AF. Exposure to high levels of PM2.5 was associated with 10% (95% CI, 1%-20%) increased odds of hospitalizations for cardiovascular disease. Specifically, high PM2.5 was associated with 24% (95% CI, 3%-48%) increased odds of hospitalization and 34% (95% CI, 6%-70%) higher odds of emergency department visits for all AF-related diagnoses. We did not observe significant interaction effects between PM2.5 and extreme heat on the risk of hospitalization or emergency department visits for cardiovascular disease or AF.
CONCLUSION: On days with elevated PM2.5 levels, patients with AF were associated with higher odds of AF-related or cardiovascular hospitalizations and emergency department visits, highlighting the need for targeted prevention strategies to protect vulnerable populations from the adverse effects of air pollution.