Key result
Higher PM2.5 exposure is linked to ~30% higher MACE risk after ACS per IQR increase.
Why the study?
Little is known about whether PM2.5 exposure influences the incidence of major adverse cardiovascular events in ACS patients after hospital discharge.
Does PM2.5 exposure increase the incidence of MACE in ACS patients after hospital discharge?
Cohort (n=5,407)
Yes
Does PM2.5 exposure increase the incidence of MACE in ACS patients after hospital discharge?
Answers are grounded in this paper and cite their sources.
Exposure to PM2.5 is associated with an increased risk of MACE in ACS patients post-discharge, an effect that is exacerbated by hypertension and prior MI but mitigated by residential green space.
Reducing major adverse cardiovascular events (MACE) within one year after hospital discharge is key for the survival of patients with acute coronary syndrome (ACS). To date, little is known about whether PM 2.5 exposure could influence the incidence of MACE in ACS after discharge. To assess the association between PM 2.5 and its components with one-year MACE in ACS patients after hospital discharge, as well as the modification effects of medical history and green space. During 2017–2019, data from 5407 ACS patients were collected in Shandong Province and Beijing. The incidence of MACE was followed up within one year after discharge. The average concentrations of PM 2.5 and its major components including sulfate, nitrate, ammonium, organic matter, and black carbon were assigned to residential addresses. A Cox mixed-effects model was applied to quantify the association between PM 2.5 and its components with MACE, with interactive effects estimated by medical history and greenspace. The hazard ratio (HR) of MACE was 1.30 [95 % confidence intervals (CIs): 1.16, 1.46] for each interquartile range (IQR) increase of PM 2.5 . The strongest association was observed for sulfate. Patients with hypertension and previous myocardial infarction were more susceptible to PM 2.5 exposure than other medical history factors. High greenspace within a 1,000-m radius of residential address can substantially mitigate PM 2.5 adverse effect. Exposure to PM 2.5 and its components was related to increase incidence of MACE in ACS patients. Public health priority should be provided to individuals with certain medical history and to greenspace expansion. • PM 2.5 and its components exposure is related to increased incidence of MACE. • Among the PM 2.5 components associated with MACE, SO 4 2- is the key component. • Patients with hypertension and MI are more vulnerable to PM 2.5 -related risk of MACE. • Higher green space may be beneficial for reducing the PM 2.5 -related risk of MACE.
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Chu et al. (2025) conducted a cohort in acute coronary syndrome (ACS) (n=5,407). PM2.5 exposure was evaluated on major adverse cardiovascular events (MACE) (HR 1.30, 95% CI 1.16, 1.46). Each interquartile range increase in PM2.5 exposure was associated with an increased risk of major adverse cardiovascular events in ACS patients (HR 1.30; 95% CI 1.16-1.46).
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