Daily Exposure to Air Pollution Particulate Matter Is Associated with Atrial Fibrillation in High-Risk Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Patient Sample
2.2. Procedures
2.3. Environmental Data
2.4. Statistical Analyses
3. Results
4. Discussion
Study Limitations
5. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
AB = atrial burden |
AF = atrial fibrillation |
CI = confidence interval |
ICD = implantable cardioverter-defibrillator |
ICD-CRT = cardiac resynchronization therapy defibrillators |
IQR = interquartile range |
OR = Odds Ratio |
PM2.5 = particulate matter of less than 2.5 μm in aerodynamic diameter |
PM10 = particulate matter of less than 10 μm in aerodynamic diameter |
WHO = World Health Organization |
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Patients (n = 145) | ||
---|---|---|
Men | 109 (75.2) | |
Age (years) | 72.00 [64.00, 77.00] | |
Smokers | 12 (8.3) | |
Hypertensive cardiomyopathy | 16 (11.0) | |
Myocardial infarction | 40 (27.6) | |
Valvular heart disease | 6 (4.1) | |
Dilated cardiomyopathy | 45 (31) | |
Hypertrophic cardiomyopathy | 2 (1.4) | |
Treatments | ||
Antiarrhythmics drugs | 29 (20.0) | |
β-blockers | 81 (55.9) | |
ACE inhibitors | 68 (46.9) | |
Diuretics | 74 (51.0) | |
Spironolactone | 8 (5.5) | |
Calcium-antagonists | 21 (14.5) | |
α-blockers | 3 (2.1) | |
Ivabradine | 1 (0.7) | |
Digitalis | 5 (3.4) | |
Nitrates | 7 (4.8) | |
Antiplatelet | 73 (50.3) | |
Oral anticoagulant | 31 (21.4) | |
NYHA class | I | 45 (51.1) |
II | 35 (39.8) | |
III | 8 (9.1) | |
IV | 0 | |
Comorbidities | ||
Hypertension | 70 (48.3) | |
Diabetes | 30 (20.7) | |
Kidney failure | 8 (5.5) | |
Previous stroke or TIA | 11 (7.6) | |
Chronic Obstructive Pulmonary Disease | 12 (8.3) |
Pollutants | |
---|---|
PM2.5 (μg/m3) | 16.00 [10.00, 26.00] |
Days PM2.5 over the threshold | 9697 (26.2%) |
PM10 (μg/m3) | 26.00 [15.50, 42.50] |
Days PM10 over the threshold | 3704 (18.3%) |
Effects | Odds Ratio | 95% CI | p-Value (Nonlinearity) | |
---|---|---|---|---|
Univariable model | ||||
PM2.5 | 75 vs. 25 | 1.98 | 1.22–3.22 | 0.002 |
PM10 | 100 vs. 50 | 2.64 | 1.02–6.83 | 0.249 |
Adjusted model and Firth corrected | ||||
PM2.5 | 75 vs. 25 | 1.80 | 1.34–2.40 | 0.01 |
PM10 | 100 vs. 50 | 2.48 | 1.44–4.28 | 0.01 |
Pollutant | Effect | OR (95% CI) Lag 0 | OR (95% CI) Lag 1 | OR (95% CI) Lag 2 |
---|---|---|---|---|
PM2.5 | 75 vs. 25 | 3.46 (1.36–8.74) | 1.42 (0.56–3.59) | 1.21 (0.70–2.10) |
PM10 | 100 vs. 50 | 3.74 (2.52–5.55) | 1.48 (0.90–2.42) | 0.69 (0.44–1.06) |
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Gallo, E.; Folino, F.; Buja, G.; Zanotto, G.; Bottigliengo, D.; Comoretto, R.; Marras, E.; Allocca, G.; Vaccari, D.; Gasparini, G.; et al. Daily Exposure to Air Pollution Particulate Matter Is Associated with Atrial Fibrillation in High-Risk Patients. Int. J. Environ. Res. Public Health 2020, 17, 6017. https://doi.org/10.3390/ijerph17176017
Gallo E, Folino F, Buja G, Zanotto G, Bottigliengo D, Comoretto R, Marras E, Allocca G, Vaccari D, Gasparini G, et al. Daily Exposure to Air Pollution Particulate Matter Is Associated with Atrial Fibrillation in High-Risk Patients. International Journal of Environmental Research and Public Health. 2020; 17(17):6017. https://doi.org/10.3390/ijerph17176017
Chicago/Turabian StyleGallo, Elisa, Franco Folino, Gianfranco Buja, Gabriele Zanotto, Daniele Bottigliengo, Rosanna Comoretto, Elena Marras, Giuseppe Allocca, Diego Vaccari, Gianni Gasparini, and et al. 2020. "Daily Exposure to Air Pollution Particulate Matter Is Associated with Atrial Fibrillation in High-Risk Patients" International Journal of Environmental Research and Public Health 17, no. 17: 6017. https://doi.org/10.3390/ijerph17176017