Air Pollution and Hospitalization for Acute Myocardial Infarction in China

• Published in: The American journal of cardiology Vol. 120; no. 5; pp. 753 - 758
• Main Authors: Liu, Hui, PhD, Tian, Yaohua, PhD, Xiang, Xiao, PhD, Sun, Kexin, PhD, Juan, Juan, PhD, Song, Jing, PhD, Cao, Yaying, PhD, Xu, Beibei, PhD, Hu, Yonghua, MD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2017; Elsevier Limited
• Subjects: Aged; Air pollution; Air Pollution - adverse effects; Carbon monoxide; Cardiovascular; China - epidemiology; Cities; Confidence intervals; Cross-Over Studies; Developing countries; Female; Follow-Up Studies; Heart attacks; Heart rate; Hospitalization; Hospitalization - trends; Hospitals; Humans; Humidity; Incidence; Industrialized nations; LDCs; Male; Middle Aged; Monitoring systems; Morbidity; Myocardial infarction; Myocardial Infarction - epidemiology; Myocardial Infarction - therapy; Nitrogen dioxide; Outdoor air quality; Ozone; Particulate matter; Pollutants; Pollution; Pollution effects; Public health; Regression analysis; Retrospective Studies; Risk Assessment; Seasons; Sulfur; Sulfur dioxide; Time Factors; China; air pollution; hospitalization; China; myocardial infarction
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2017.06.004

Abstract There is growing interest in the association between ambient air pollution and acute myocardial infarction (AMI). The objective of this study was to explore the association in 14 Chinese cities using a time-stratified case-crossover design. We identified 80,787 hospital admissions for AMI between January 1, 2014, and December 31, 2015 from electronic hospitalization summary reports. Conditional logistic regression was used to estimate the percent changes with 95% confidence intervals (CIs) in AMI admissions in relation to an interquartile range (IQR) increase in ambient air pollutant concentrations. All analyzed air pollutants, with the exception of ozone, were positively associated with daily AMI admissions on lag2 and lag3 days. An IQR increase in particulate matter <10 µm in aerodynamic diameter, sulfur dioxide, nitrogen dioxide, and carbon monoxide concentrations on lag2 day was significantly associated with a 0.8% (95% CI: 0.1%, 1.6%), 2.0% (95% CI: 1.2%, 2.9%), 2.2% (95% CI: 1.4%, 3.1%), and 1.1% (95% CI: 0.4%, 1.8%) increase in AMI admissions, respectively. We also observed a significant association in relation to ozone on lag4 day (percent change: 1.3%; 95% CI: 0.2%, 2.4%). Subgroup analyses indicated no effect modification of risk by age (≥65 years and <65 years) or sex. In conclusion, this is the first multi-city study in China, or even in other developing countries, to report the short-term effects of air pollution on AMI morbidity. Our findings contribute to the limited scientific data on the effects of ambient air pollution on AMI in developing countries.