A 10 µg/m3 increase in PM2.5 exposure was associated with increased incidence of CVD events (HR 1.07; 95% CI 1.03-1.10) among COPD patients with a history of severe exacerbation.
Cohort (n=152,988)
Yes
Does long-term exposure to PM10 and PM2.5 increase the incidence of CVD events and lung cancer in patients with COPD?
Long-term exposure to particulate matter is associated with an increased risk of cardiovascular events and stroke in COPD patients with a history of severe exacerbations.
Effect estimate: HR 1.07 (95% CI 1.03-1.10)
Abstract Rationale Chronic obstructive pulmonary disease (COPD) is a systemic inflammatory condition often accompanied by comorbidities such as cardiovascular disease (CVD) and lung cancer, which substantially contribute to morbidity and mortality. Due to chronic inflammation and impaired cardiopulmonary reserve, COPD patients may be particularly susceptible to air pollution. Although long-term exposure to particulate matter (PM10 and PM2.5) has been linked to CVD and lung cancer in the general population, evidence among COPD patients, especially by severe exacerbation history, remains limited.Therefore, we aimed to investigate the associations of long-term exposure to PM10 and PM2.5 with incidence of CVD event and lung cancer in a large cohort of COPD patients, stratified by their history of severe exacerbation. Methods We used a nationwide retrospective cohort study of 152,988 adults aged 40 years and older who were diagnosed with COPD between January 1, 2006 and December 31, 2022. COPD was defined as the presence of ICD-10 codes for COPD and a prescription of COPD medications at least 2 times in study period. Exposure to PM10 and PM2.5 was estimated at a 1-km2 resolution using Community Multiscale Air Quality model combined with regression-based calibration. We estimated the hazard ratios (HRs) for incidence of CVD events including MI, atrial fibrillation, heart failure and stroke and Lung cancer with a 10 µg/m3 increase in the 1-year average concentrations of PM10 and PM2.5 using multi-variable adjusted, time-varying Cox proportional hazards models. Results In the fully adjusted models, among patients with a history of severe exacerbation, a 10µg/m3 increase in PM2.5 exposure was significantly associated with incidence of CVD event (HR: 1.07, 95% CI: 1.03, 1.10) and Stroke (HR: 1.12, 95% CI: 1.05, 1.18). The HRs for incidence of CVD event and stroke with a 10 µg/m3 increase in 1-year average concentration of PM10 were 1.04(95% CI:1.02, 1.06) and 1.05(95% CI:1.01, 1.09). For patients without a history of severe exacerbation, HRs for incidence of lung cancer with a 10 µg/m3 increase in 1-year PM10 and PM2.5 exposures were 1.07(95% CI:1.01, 1.12) and 1.13(95% CI:1.04, 1.22), respectively. Conclusions In this large retrospective cohort of COPD patients, long-term exposure to PM was associated with an increased incidence of cardiovascular events and stroke among patients with a history of severe exacerbation, whereas it was associated with an increased incidence of lung cancer among those without a history of severe exacerbation. This abstract is funded by: None
Lee et al. (Fri,) conducted a cohort in Chronic obstructive pulmonary disease (COPD) (n=152,988). Long-term exposure to PM10 and PM2.5 was evaluated on Incidence of CVD event (per 10 µg/m3 increase in PM2.5 among patients with severe exacerbation history) (HR 1.07, 95% CI 1.03-1.10). A 10 µg/m3 increase in PM2.5 exposure was associated with increased incidence of CVD events (HR 1.07; 95% CI 1.03-1.10) among COPD patients with a history of severe exacerbation.