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JNKUMS 2018, 9(3): 324-329 Back to browse issues page
The Association between Air Quality Index and Risk of Developing ST Segment Elevation Myocardial Infarction: A Case-Crossover Design
Isa Khaheshi 1, Amirsina Sharifi 2, Negin Yousefi 1, Mohammadreza Naderian 3, Negin Nickdoost 1, Mohammad Ali Akbarzadeh 1
1- Cardiovascular Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
2- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
3- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
Abstract:   (530 Views)
Introduction: Air pollution is one of the most important environmental health threats of our time worldwide, including Iran. Air pollution is a major risk factor threating public health. The overall aim of this study was to determine the relationship between air quality and the incidence of acute myocardial infarction in Tehran.
Methods: In this case crossover study, the association between Air Quality Index (AQI) of Tehran and the risk of developing ST-Elevation Myocardial Infarction (STEMI) in patients referring to Tehran Modarres Hospital was investigated during 2 years. Data regarding air quality index were gathered from the Tehran meteorological organization. Air quality index during the 24 hours before STEMI was gathered as case periods and data of air pollutions on one, two and three weeks before the event was collected as control periods. Data analysis was performed using SPSS statistical software. Logistic regression was used to compare air pollutants exposure during case and control periods.
Results: The current study included 208 patients admitted with a diagnosis of STEMI. A positive correlation was detected between average AQI in 24 hours before infarction and STEMI (OR: 1.006; CI: 95%; 1.011-1.001). In other words, for each 10-fold increase in AQI, the risk of STEMI increases by 0.6% for each person. Furthermore, STEMI was increased more significantly in male, people over the age of 60, and diabetic patients according to increase of AQI.
Conclusions: The results of this study showed that air pollution increases the risk of acute myocardial infarction. Thus, more restrictive legislations should be applied to define a safe level of air pollutant production
Keywords: Air Pollution, Air Quality Index, ST Elevation Myocardial, Infarction, Crossover Study
Full-Text [PDF 467 kb]   (135 Downloads)    
Type of Study: Orginal Research | Subject: Basic Sciences
Received: 2017/12/31 | Accepted: 2017/12/31 | Published: 2017/12/31
References
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19. Di Cesare M, Khang YH, Asaria P, Blakely T, Cowan MJ, Farzadfar F, et al. Inequalities in non-communicable diseases and effective responses. Lancet. 2013;381(9866):585-97. DOI: 10.1016/S0140-6736(12)61851-0PMID: 23410608
20. Organization WH. Global status report on alcohol and health. Organization WH, Unit WHOMoSA, 2014.
21. Culic V. Acute risk factors for myocardial infarction. Int J Cardiol. 2007;117(2):260-9. DOI: 10.1016/j.ijcard.2006.05.011PMID: 16860887
22. Poursafa P, Mansourian M, Motlagh ME, Ardalan G, Kelishadi R. Is air quality index associated with cardiometabolic risk factors in adolescents? The CASPIAN-III Study. Environ Res. 2014;134:105-9. DOI: 10.1016/j.envres.2014.07.010PMID: 25127520
23. Cheng WL, Chen YS, Zhang J, Lyons TJ, Pai JL, Chang SH. Comparison of the Revised Air Quality Index with the PSI and AQI indices. Sci Total Environ. 2007;382(2-3):191-8. DOI: 10.1016/j.scitotenv.2007.04.036PMID: 17540435
24. Maclure M. The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol. 1991;133(2):144-53. PMID: 1985444 [DOI:10.1093/oxfordjournals.aje.a115853]
25. Qorbani M, Yunesian M, Fotouhi A, Zeraati H, Sadeghian S, Rashidi Y. Relation between Air Pollution Exposure and Onset of Acute Coronary Syndrome in Tehran Heart Center Using a Case-Crossover Design. Iranian J Epidemiol. 2007;3(1):53-9.
26. Ruidavets JB, Cournot M, Cassadou S, Giroux M, Meybeck M, Ferrieres J. Ozone air pollution is associated with acute myocardial infarction. Circulation. 2005;111(5):563-9. DOI: 10.1161/01.CIR.0000154546.32135.6EPMID: 15699276
27. Argacha JF, Collart P, Wauters A, Kayaert P, Lochy S, Schoors D, et al. Air pollution and ST-elevation myocardial infarction: A case-crossover study of the Belgian STEMI registry 2009-2013. Int J Cardiol. 2016;223:300-5. DOI: 10.1016/j.ijcard.2016.07.191PMID: 27541680
28. Gardner B, Ling F, Hopke PK, Frampton MW, Utell MJ, Zareba W, et al. Ambient fine particulate air pollution triggers ST-elevation myocardial infarction, but not non-ST elevation myocardial infarction: a case-crossover study. Part Fibre Toxicol. 2014;11:1. DOI: 10.1186/1743-8977-11-1PMID: 24382024
29. Janes H, Sheppard L, Lumley T. Case-crossover analyses of air pollution exposure data: referent selection strategies and their implications for bias. Epidemiology. 2005;16(6):717-26. PMID: 16222160 [DOI:10.1097/01.ede.0000181315.18836.9d]
30. Brook RD, Franklin B, Cascio W, Hong Y, Howard G, Lipsett M, et al. Air pollution and cardiovascular disease: a statement for healthcare professionals from the Expert Panel on Population and Prevention Science of the American Heart Association. Circulation. 2004;109(21):2655-71. DOI: 10.1161/01.CIR.0000128587.30041.C8PMID: 15173049
31. Zanobetti A, Franklin M, Koutrakis P, Schwartz J. Fine particulate air pollution and its components in association with cause-specific emergency admissions. Environ Health. 2009;8:58. DOI: 10.1186/1476-069X-8-58PMID: 20025755
32. Butland BK, Atkinson RW, Milojevic A, Heal MR, Doherty RM, Armstrong BG, et al. Myocardial infarction, ST-elevation and non-ST-elevation myocardial infarction and modelled daily pollution concentrations: a case-crossover analysis of MINAP data. Open Heart. 2016;3(2):e000429. DOI: 10.1136/openhrt-2016-000429PMID: 27621827
33. Nuvolone D, Balzi D, Chini M, Scala D, Giovannini F, Barchielli A. Short-term association between ambient air pollution and risk of hospitalization for acute myocardial infarction: results of the cardiovascular risk and air pollution in Tuscany (RISCAT) study. Am J Epidemiol. 2011;174(1):63-71. DOI: 10.1093/aje/kwr046PMID: 21597098
34. Peters A, Dockery DW, Muller JE, Mittleman MA. Increased particulate air pollution and the triggering of myocardial infarction. Circulation. 2001;103(23):2810-5. PMID: 11401937 [DOI:10.1161/01.CIR.103.23.2810]
35. Wang XD, Zhang XM, Zhuang SW, Luo Y, Kang S, Liu YL. Short-term effects of air pollution on acute myocardial infarctions in Shanghai, China, 2013-2014. J Geriatr Cardiol. 2016;13(2):132-7. DOI: 10.11909/j.issn.1671-5411.2016.02.005PMID: 27168738
36. Mustafic H, Jabre P, Caussin C, Murad MH, Escolano S, Tafflet M, et al. Main air pollutants and myocardial infarction: a systematic review and meta-analysis. JAMA. 2012;307(7):713-21. DOI: 10.1001/jama.2012.126PMID: 22337682
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Khaheshi I, Sharifi A, Yousefi N, Naderian M, Nickdoost N, Akbarzadeh M A. The Association between Air Quality Index and Risk of Developing ST Segment Elevation Myocardial Infarction: A Case-Crossover Design. JNKUMS. 2018; 9 (3) :324-329
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Volume 9, Issue 3 (1-2018) Back to browse issues page
مجله دانشگاه علوم پزشکی خراسان شمالی Journal of North Khorasan University of Medical Sciences
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