The Association Between Air Pollution and Relative Incidence of ST-Elevation Myocardial Infarction Compared With Non-ST-Elevation Myocardial Infarction

초록

Background Myocardial infarction is a cause of mortality worldwide. Previous studies have indicated the association MI with Air Pollution (AP). Nonetheless, there are limited information on the long-term effect of air pollutants for relative incidence rates of ST-segment elevation myocardial infarction (STEMI) and Non-ST-Elevation Myocardial Infarction (NSTEMI). We investigated the association between annual average concentration of air pollutants and the relative incidence of STEMI compared to NSTEMI. Methods The study subjects were enrolled in Korea Acute Myocardial Infarction (KAMIR) and Korea Acute Myocardial Infarction-National Institutes of Health (KAMIR-NIH). A total of eligible 45,619 AMI patients were enrolled from January 2006 to December 2015. All statistical analyses were conducted in R version 4.1.2. Mixed-effect regression models were used to examine the association of an annual average of ambient AP before MI onset for the incidence rate of STEMI compared with NSTEMI. Results After mixed-effect regression model analysis, each 1 μg/m3 increase in PM10 was associated with increased incidence of STEMI compared with NSTEMI (odds ratio [OR]:1.009, 95% Confidence Interval [CI]: 1.002 - 1.016; p=0.012). For In-Hospital Cardiogenic Shock Complication, PM10 per Each 1 μg/m3 increase, SO2 per 1 part per billion (ppb) increase were associated with an increased risk: PM10 (OR:1.033, 95% CI, 1.018 - 1.050; p<0.001), SO2 (OR:1.104, 95% CI, 1.006 - 1.212; p=0.037), respectively. Conclusion A higher concentration of air pollutants, particularly PM10, was an environmental risk factor for increased rate of developing STEMI. PM10 and SO2 were found to be risk factors for In-Hospital Cardiogenic Shock Complication. The strategy to reduce AP exposure would be needed to prevent STEMI incidence and severe cardiovascular complications.