In patients with coronary artery disease, higher PM2.5 exposure was independently associated with an increased risk of major adverse cardiovascular events (HR 1.73).
Cohort (n=1,602)
No
Does high environmental pollution exposure increase the risk of MACE in patients with high-risk CAD?
In patients with CAD, higher PM₂.₅ exposure is independently associated with an increased risk of MACE, and social vulnerability amplifies the adverse risk relationships for NOx exposure.
Effect estimate: HR 1.73 (95% CI 1.22-2.44)
p-value: p=0.002
Objectives/Goals: To assess the association between pollution and CVD outcomes in a high-risk CAD population, and investigate how social drivers intersect with this association. Methods/Study Population: 1, 602 participants enrolled in the Emory Cardiovascular Biobank were stratified into high vs. low pollutant exposure groups based on PM₂. ₅ (median 10. 6 μg/m³), NO x (median 39. 4 ppb), and CO (median 635 ppb) levels. Demographics, cardiovascular (CV) risk factors, comorbidities, and SVI domains including socioeconomic status (RPLTHEME1), household characteristics (RPLTHEME2), racial/ethnic minority status (RPLTHEME3), housing and transportation (RPLTHEME4), and overall SVI ranking (RPLTHEMES) were compared between groups. Cox proportional hazards models were used to assess associations between pollutants and CVD outcomes (CV death, myocardial infarction MI, stroke, heart failure, and the composite MACE. Results/Anticipated Results: Higher PM₂. ₅ exposure was associated with a greater prevalence of hypertension (82. 7% vs. 74. 6%, p<0. 001), female sex (39. 7% vs. 34. 1%, p=0. 023), and elevated SVI scores (RPLTHEME1–4, all p<0. 05). Similar gradients were observed across NO x and CO strata, particularly in SVI metrics (p<0. 001). In fully adjusted models, MACE were associated with PM₂. ₅ (HR 1. 73, 95% CI: 1. 22–2. 44, p = 0. 002) and CO (HR 1. 00, 95% CI: 1. 0005–1. 003, p = 0. 005) levels. Additionally, HF admissions were associated with PM₂. ₅ levels (HR 1. 16, 95% CI: 1. 05–1. 28, p = 0. 003). SVI measures interacted significantly with the impact of NO x on HF risk RPLTHEME1 (HR 1. 03, p = 0. 033) and RPLTHEME2 (HR 1. 05, p = 0. 008) and stroke risk RPLTHEME4 (HR 1. 07, p = 0. 025). Discussion/Significance of Impact: In patients with CAD, higher PM₂. ₅ exposure is independently associated with risk of MACE. Social vulnerability amplified the adverse risk relationships for NO x exposure highlighting the need to consider neighborhood-level risk in pollution-related CV disease prevention.
Harris et al. (Wed,) conducted a cohort in Coronary Artery Disease (CAD) (n=1,602). High PM2.5 exposure vs. Low PM2.5 exposure was evaluated on Major Adverse Cardiovascular Events (MACE) (HR 1.73, 95% CI 1.22-2.44, p=0.002). In patients with coronary artery disease, higher PM2.5 exposure was independently associated with an increased risk of major adverse cardiovascular events (HR 1.73).