Particulate air pollution as a risk factor for ST-segment depression in patients with coronary artery disease

Kai Jen Chuang, Brent A. Coull, Antonella Zanobetti, Helen Suh, Joel Schwartz, Peter H. Stone, Auguste Litonjua, Frank E. Speizer, Diane R. Gold

研究成果: 雜誌貢獻文章同行評審

66 引文 斯高帕斯(Scopus)

摘要

Background - The association of particulate matter (PM) with cardiovascular morbidity and mortality is well documented. PM-induced ischemia is considered a potential mechanism linking PM to adverse cardiovascular outcomes. Methods and Results - In a repeated-measures study including 5979 observations on 48 patients 43 to 75 years of age, we investigated associations of ambient pollution with ST-segment level changes averaged over half-hour periods measured in the modified V5 position by 24-hour Holter ECG monitoring. Each patient was observed up to 4 times within 1 year after a percutaneous intervention for myocardial infarction, acute coronary syndrome without infarction, or stable coronary artery disease without acute coronary syndrome. Elevation in fine particles (PM2.5) and black carbon levels predicted depression of half-hour-averaged ST-segment levels. An interquartile increase in the previous 24-hour mean black carbon level was associated with a 1.50-fold increased risk of ST-segment depression ≥0.1 mm (95% CI, 1.19 to 1.89) and a -0.031-mm (95% CI, -0.042 to -0.019) decrease in half-hour-averaged ST-segment level (continuous outcome). Effects were greatest within the first month after hospitalization and for patients with myocardial infarction during hospitalization or with diabetes. Conclusions - ST-segment depression is associated with increased exposure to PM2.5 and black carbon in cardiac patients. The risk of pollution-associated ST-segment depression may be greatest in those with myocardial injury in the first month after the cardiac event.

原文英語
頁(從 - 到)1314-1320
頁數7
期刊Circulation
118
發行號13
DOIs
出版狀態已發佈 - 九月 23 2008

ASJC Scopus subject areas

  • 心臟病學與心血管醫學
  • 生理學(醫學)

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