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Long-term air pollution exposure may lead to higher mortality in prior MI

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Increased exposure to particulate matter and ozone was associated with a worse 1-year health status following MI, while particulate matter was linked to an increased risk for death at 5 years, researchers reported.

Ali O. Malik, MD, and colleagues sought to determine the effect of exposure to particulate matter < 2.5 µm in diameter (PM_2.5) and ozone to the health status of quality of life of patients with MI. The findings were presented at the American Heart Association Quality of Care and Outcomes Research Scientific Sessions and published in Circulation: Cardiovascular Quality and Outcomes.

“Beyond mortality, patients are equally or more concerned about their health status: their symptoms, function and quality of life,” Malik, a cardiovascular outcomes research and clinical cardiology fellow at the department of cardiology at St. Luke’s Mid America Heart Institute and the University of Missouri-Kansas City, and colleagues wrote in the study. “To date, there have been no studies examining the association between exposure to PM_2.5 and ozone with patients’ health status among patients with coronary artery disease.”

Malik and colleagues analyzed data from the TRIUMPH and PREMIER registries consisting of patients with MI from 31 U.S. hospitals between 2003 and 2008. After 1 year, patients were assessed with the Seattle Angina Questionnaire, with 5-year mortality being assessed with the CDC National Death Index.

In adjusted models, increased PM_2.5 and ozone exposure had an independent association with poorer Seattle Angina Questionnaire summary scores at 1 year (Beta estimate per +1 SD increase in PM_2.5 = –0.8; 95% CI, –1.4 to –0.3; P = .002; Beta estimate per +1 SD increase in ozone = –0.9; 95% CI, –1.3 to –0.4; P < .001), the researchers wrote.

Higher PM_2.5 exposure was independently associated with greater mortality risk (HR = 1.13 per +SD; 95% CI, 1.07-1.2; P < .001), Malik and colleagues wrote.

Increased exposure to particulate matter and ozone was associated with a worse 1-year health status following MI, while particulate matter was linked to an increased risk for death at 5 years, researchers reported.

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According to the researchers, the findings suggest that greater air pollution not only increases patients’ risk for death but also worsens symptoms, function and quality of life.

“While further studies are needed to determine the mechanism of this increased risk, ongoing debates about the regulation of air pollution should consider the impact of higher exposure to PM_2.5 and ozone on patients’ health status,” Malik and colleagues wrote. – by Earl Holland Jr.

References:

Malik AO, et al. Presentation 2. Presented at: AHA Quality of Care and Outcomes Research Scientific Sessions; April 5-6, 2019; Arlington, Va.

Malik AO, et al. Circ Cardiovasc Qual Outcomes. 2019;doi:10.1161/CIRCOUTCOMES.119.05598.

Disclosures: Malik reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.