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The EP-PARTICLES study was created to assess the impact of air pollution on the health and mortality of the population of Eastern Poland. The biggest cities of the region are Lublin, Białystok, Olsztyn, Rzeszow, and Kielce, whose inhabitants constitute less than 25% of the total population of the analyzed region. The vast majority of air pollution studies to date have been conducted in heavily polluted areas, where patients are exposed to moderate to extreme concentrations of pollutants. The composition of the pollution itself is also not without significance, as it differs significantly from the types of smog we are familiar with. The type of air pollution known as Polish smog is rich in compounds such as PM2.5, PM10, and polycyclic aromatic hydrocarbons (benzo(a)pyrene) from low emissions associated with household heating with solid fuels (coal, wood, and often also waste) and imposes detrimental effects on the health and life of the population, in particular in the context of cardiovascular effects. In this publication, we aimed to present the baseline results of the EP-PARTICLES investigators' research up to this point and propose steps aimed at changing the state of air quality and reducing existing exposure. Fields covered so far include atrial fibrillation, acute coronary syndromes, ischemic stroke, heart failure, renal function, and cardiovascular mortality. [ABSTRACT FROM AUTHOR]

Coexistence of chronic kidney disease (CKD) in the case of acute coronary syndromes (ACS) significantly worsens the outcomes. The aim of our study was to assess renal function impact on mortality among patients with ACS. The study was based on records of 21,985 patients hospitalized in the Medical University of Bialystok in 2009–2015. Inclusion criteria were ACS. Exclusion criteria were: death within 24 h of admission, eGFR <15 ml/min/1.73 m2, hemodialysis. Mean observation time was 2296 days. Criteria were met by 2213 patients. CKD occurred in 24.1% (N = 533) and more often affected those with NSTEMI (26.2 (337) vs. 21.2 (196), p =.006). STEMI patients had higher incidence of post-contrast acute kidney injury (PC-AKI) (5 (46) vs. 4.1 (53), p <.001). During the study, 705 people died (31.9%), more often with NSTEMI (33.2% (428) vs. 29.95% (277), p <.001). However, from a group of patients suffering from PC-AKI 57.6% died. The risk of PC-AKI increased with creatinine concentration (RR: 2.990, 95%CI: 1.567–5.721, p <.001), occurrence of diabetes mellitus (RR: 2.143, 95%CI: 1.029–4.463, p =.042), atrial fibrillation (RR: 2.289, 95%CI: 1.056–4.959, p =.036). Risk of death was greater with an increase in postprocedural creatinine concentration (RR: 2.254, 95%CI: 1.481–3.424, p <.001). PC-AKI is a major complication in patients with ACS, occurs more frequently in STEMI and may be a prognostic marker of long-term mortality in patients undergoing percutaneous coronary intervention (PCI). More attention should be given to the prevention and diagnosis of PC-AKI but necessary PCI should not be withheld in fear of PC-AKI. [ABSTRACT FROM AUTHOR]

Introduction: The clinical courses of takotsubo syndrome (TS) and of acute coronary syndromes (ACS) seem to be very similar. However, there is limited knowledge about risk factors of poor outcomes. Low body mass index worsens the prognosis of patients with cardiovascular diseases, especially those undergoing surgical treatment. The aim of the study was to evaluate the influence of the body mass index (BMI) on the prognosis in patients diagnosed with TS.Material and Methods: Eighty patients aged 15-89 (mean: 67.9 years), 74 women and 6 men with TS diagnosis according to Mayo Clinic diagnostic criteria were divided into 3 groups: low body mass (BMI < 18.5 kg/m2), normal body mass (18.5 ≥ BMI < 25 kg/m2) and excessive body mass (BMI ≥ 25 kg/m2).Results: Patients with low BMI were older, but with less prevalent risk factors such as hypertension, hypercholesterolemia and positive family history of coronary artery disease and more frequent risk factors such as cigarette smoking, chronic obstructive pulmonary disease (COPD), depressive and anxiety disorders as well as malignancy. They also had higher haemoglobin, lower troponin, creatine kinase, C-reactive protein and lipid fractions. The highest annual, 3-year and 5-year mortality was observed in the group with BMI < 18.5 kg/m2. None of the patients with low BMI survived the 5-year follow-up period (100% vs. 25% vs. 15.2%; p < 0.0001). In group III, mortality among overweight patients (25 ≥ BMI < 30 kg/m2) was 8.3%, and in obese people (BMI ≥ 30 kg/m2) 1 out 5 patients died during follow-up.Conclusions: The majority of typical cardiovascular risk factors are less frequently observed in patients with TS and low body mass. Early prognosis for TS patients and low BMI is relatively favourable, whereas the 5-year follow-up is associated with extremely high mortality. Overweight patients have the best prognosis in the long-term follow-up. [ABSTRACT FROM AUTHOR]

Introduction: Valvular heart diseases (VHD) are a significant problem in the Polish population. Coexistence of coronary artery disease (CAD) in patients with VHD increases the risk of death and affects the further therapeutic strategy. Aim: Analysis of atherosclerotic plaque burden distribution in coronary arteries and long-term prognosis among patients with VHD. Material and methods: Inclusion criteria were met by 1025 patients with moderate and severe VHD. Mean observation time was 2528 ±1454 days. Results: Severe aortic valve stenosis (AVS) occurred in 28.2%, severe mitral valve insufficiency (MVI) in 20%. CAD with severe angiographic stenoses was noted in 42.3% (n = 434). Among patients with severe MVI, CAD was noted in 47.1% of cases, and prior acute coronary syndromes (ACS) in 27.1% of patients (n = 58). In severe AVS patients, significant angiographic atherosclerotic changes were observed in 29.6% (n = 86), and prior ACS in 7.6% (n = 22) of patients. During the observation 52.7% of patients died, including 62.9% of patients with severe MVI and 51.6% of those with severe AVS. Age (OR = 1.038; 95% CI: 1.005-1.072; p = 0.022) and coexisting aortic valve insufficiency (AVI) (OR = 2.39, 95% CI: 5.370-11.065, p = 0.035) increased the mortality rate. Conclusions: Severe AVS is starting to be the most prevalent VHD. CAD is one of the most significant factors deteriorating prognosis of patients with VHD. AVI and age were significant risk factors for mortality. The worst prognosis was observed in severe MVI, which may result from more frequent occurrence of CAD in this group. A lesser burden of CAD and ACS in the group of patients with severe AVS did not affect survival. [ABSTRACT FROM AUTHOR]

Introduction: Stroke is the second leading cause of long-term disability and death worldwide. Diabetes and hyperglycemia may impact the outcome of stroke. We examined the impact of hyperglycemia and diabetes on in-hospital death among ischemic and hemorrhagic stroke patients.Material and Methods: Data from 766 consecutive patients with ischemic (83.15%) and hemorrhagic stroke were analyzed. Patients were classified into four groups: ischemic and diabetic; ischemic and non-diabetic; hemorrhagic and diabetic; and hemorrhagic and non-diabetic. Serum glucose was measured on admission at the emergency department together with biochemical and clinical parameters.Results: Mean admission glucose in ischemic stroke patients with diabetes was higher than in non-diabetic ones (p < 0.001) and in hemorrhagic stroke patients with diabetes than in those without diabetes (p < 0.05). Mean admission glucose in all patients who died was significantly higher than in patients who survived. In multivariate analysis, the risk factors for outcome in patients with ischemic stroke and without diabetes were age, admission glucose level and estimated glomerular filtration rate (eGFR), while in diabetics they were female gender, admission glucose level, and eGFR; in patients with hemorrhagic stroke and without diabetes they were age and admission glucose levels. The cut-off value in predicting death in patients with ischemic stroke and without diabetes was above 113.5 mg/dl, while in diabetics it was above 210.5 mg/dl.Conclusions: Hyperglycemia on admission is associated with worsened clinical outcome and increased risk of in-hospital death in ischemic and hemorrhagic stroke patients. Diabetes increased the risk of in-hospital death in hemorrhagic stroke patients, but not in ischemic ones. [ABSTRACT FROM AUTHOR]

Introduction: Satisfaction with nursing care is the most important index of patients' general satisfaction. Aim of the study: To assess the expectations for nursing staff held by patients with cancer and cardiovascular disorders. Material and methods: Three groups of patients: group I - 120 with early-phase cancer diseases, group II - 150 with terminal-phase cancer diseases, and group III - 160 with cardiovascular disorders, completed a questionnaire involving the Social Support Scale that addressed their expectations of nurses. Results: Patients in group I regarded conscientiousness as the most desired quality of nurses, and 81.3% and 81.9% in groups II and III, respectively, agreed that it was at least important. Also comparably, 77.5% of patients in group I, 74.7% in group II, and 70.6% in group III reported having full trust in nursing staff. Concerning most important skill for nurses to have, patients in group I indicated an ability to pass medical information to patients (89.2%), those in group II indicated accuracy and gentleness in performing medical procedures (62.7%), and those in group III indicated humanitarian attitude toward patients (59.4%). Level of education of nurses did not matter to 50.8% of patients in group I, 54% in group II, and 35% in group III. Conclusions: The expectations of nursing staff concerning professional skills differed significantly depending on type and stage of disease. Patients in all groups esteemed informational and emotional support far more highly than instrumental and evaluating skills. [ABSTRACT FROM AUTHOR]

Background/Aims: We evaluated renal function and the impact of renal function on inhospital outcomes in patients with ischaemic and haemorrhagic stroke. Methods: We collected data from 766 patients with stroke; 637 (83.2 %) with ischaemic and 129 with haemorrhagic one. Results: The mean serum creatinine on admission in patients with both types of stroke, who died, was significantly higher than in those who survived. Multivariate analysis showed that independent predictors of mortality in patients with ischaemic stroke were: ischemic heart disease or prior myocardial infarction, diabetes, admission glucose and eGFR on admission. Also, multivariate analysis showed that independent predictors of mortality in patients with haemorrhagic stroke were: age and admission glucose. Conclusions: Patients with haemorrhagic stroke, in particular with acute kidney injury during hospitalisation had significantly worse outcomes than patients with ischaemic stroke. Assessment of kidney function is prerequisite to employ the necessary measures to decrease the risk of in-hospital mortality among patients with acute stroke. Appropriate approach to patients with renal dysfunction (adequate hydration, avoidance of nephrotoxic drugs, drug dose adjustment etc) should be considered as preventive and therapeutic strategies in the management of acute stroke. [ABSTRACT FROM AUTHOR]

Coronary artery disease in patients with end-stage renal disease occurs several dozen times more often than in the general population. Atherosclerotic changes in coronary arteries in dialysed patients are more diffused and calcified, which hampers the percutaneous coronary angioplasty. We present a case of an 84-year-old dialysed patient, in whom complex percutaneous coronary intervention of the left anterior descending artery was performed with the use of rotational atherectomy. [ABSTRACT FROM AUTHOR]

Copyright of Polish Journal of Cardiology / Polski Przeglad Kardiologiczny is the property of Cornetis SP. Z.O.O. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardio-Diabetological Review / Przeglad Kardiodiabetologiczny is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardio-Diabetological Review / Przeglad Kardiodiabetologiczny is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Cardio-Diabetological Review / Przeglad Kardiodiabetologiczny is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Polish Journal of Thoracic & Cardiovascular Surgery / Kardiochirurgia i Torakochirurgia Polska is the property of Termedia Publishing House and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Previous studies conducted in highly polluted areas have reported associations between air pollution and daily mortality. The Green Lungs of Poland are characterized by unique natural features and a moderate pollution level. We aimed to assess the short-term impact of air pollution on cardiovascular (CVD)-, acute coronary syndrome (ACS)-, and cerebrovascular-related (CbVD) mortality. An analysis with 4,500,000 person-years and a time-stratified case-crossover design was performed. The interquartile range increase in the PM2.5 (OR 1.036, 95% CI 1.016–1.056, p < 0.001) and PM10 concentration (OR 1.034, 95% CI 1.015–1.053, p < 0.001) was associated with increased CVD mortality on lag 0, and this effect persisted on the following days. The effects of PMs were expressed more in association with ACS-related mortality (PM2.5-OR = 1.045, 95% CI 1.012–1.080, p = 0.01; PM10-OR = 1.044, 95% CI 1.010–1.078, p = 0.01) and CbVD mortality (PM10-OR = 1.099, 95% CI 1.019–1.343, p = 0.02). We also noted a higher CVD mortality OR in the cold season for PM10 in cities with area-source domination: Białystok (p = 0.001) and Suwałki (p = 0.047). The short-term impact of PMs on cardiovascular mortality is also observed in moderately polluted areas. This adverse health effect was more apparent in CbVD- and ACS-related mortality, and in the cold season. Further research focusing on the adverse health effects of "Polish smog" is sorely needed. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) symptoms may mimic coronary artery disease (CAD) which reflects the difficulties in qualifying AF patients for invasive diagnostics. A substantial number of coronary angiographies may be unnecessary or even put patients at risk of post-contrast acute kidney injury (PC-AKI), especially patients with chronic kidney disease (CKD). We aimed to investigate the hypothesis indicating higher prevalence of PC-AKI in patients with AF scheduled for coronary angiography. The study population comprised of 8026 patients referred for elective coronarography including 1621 with AF. In the comparison of prevalence of PC-AKI in distinguished groups we can see that kidney impairment was twice more frequent in patients with AF in both groups with CKD (CKD (+)/AF (+) 6.24% vs. CKD (+)/AF (−) 3.04%) and without CKD (CKD (−)/AF (+) 2.32% vs. CKD (−)/AF (−) 1.22%). In our study, post-contrast acute kidney disease is twice more frequent in patients with AF, especially in subgroup with chronic kidney disease scheduled for coronary angiography. Additionally, having in mind results of previous studies stating that AF is associated with non-obstructive coronary lesions on angiography, patients with AF and CKD may be unnecessarily exposed to contrast agent and possible complications. [ABSTRACT FROM AUTHOR]

Background: The most serious complication of the acute Takotsubo phase is a myocardial perforation, which is rare, but it usually results in the death of the patient. Methods: In the years 2008–2020, 265 patients were added to the Podlasie Takotsubo Registry. Cardiac rupture was observed in five patients (1.89%), referred to as the Takotsubo syndrome with complications of cardiac rupture (TS+CR) group. The control group consisted of 50 consecutive patients with uncomplicated TS. The diagnosis of TS was based on the Mayo Clinic Criteria. Results: Cardiac rupture was observed in women with TS aged 74–88 years. Patients with TS and CR were older (82.20 vs. 64.84; p = 0.011), than the control group, and had higher troponin, creatine kinase, aspartate aminotransferase, and blood glucose levels (168.40 vs. 120.67; p = 0.010). The TS+CR group demonstrated a higher heart rate (95.75 vs. 68.38; p < 0.0001) and the Global Registry of Acute Coronary Events (GRACE) scores (186.20 vs. 121.24; p < 0.0001) than the control group. In patients with CR, ST segment elevation was recorded significantly more often in the III, V4, V5 and V6 leads. Left ventricular free wall rupture was noted in four patients, and in one case, rupture of the ventricular septum. In a multivariate logistic regression, the factors that increase the risk of CR in TS were high GRACE scores, and the presence of ST segment elevation in lead III. Conclusions: Cardiac rupture in TS is rare but is the most severe mechanical complication and is associated with a very high risk of death. The main risk factors for left ventricular perforation are female gender, older age, a higher concentration of cardiac enzymes, higher GRACE scores, and ST elevations shown using electrocardiogram (ECG). [ABSTRACT FROM AUTHOR]

The detrimental influence of air pollution on mortality has been established in a series of studies. The majority of them were conducted in large, highly polluted cities—there is a lack of studies from small, relatively clean regions. The aim was to analyze the short-term impact of particulate matters (PMs) on mortality in north-eastern Poland. Time-stratified case-crossover design was performed for mortality in years 2008–2017. Daily concentrations of PM2.5 (28.4 µg/m3, interquartile range (IQR) = 25.2) vs. (12.6 µg/m3, IQR = 9.0) and PM10 (29.0 µg/m3, IQR = 18.0) vs. (21.7 µg/m3, IQR = 14.5) were higher in Łomża than Suwałki (p < 0.001). Impact of PM2.5 on mortality was recorded in Łomża (odds ratio (OR) for IQR increase 1.061, 1.017–1.105, p = 0.06, lag 0) and Suwałki (OR for IQR increase 1.044, 1.001–1.089, p = 0.004, lag 0). PM10 had an impact on mortality in Łomża (OR for IQR increase 1.028, 1.000–1.058, p = 0.049, lag 1). Cardiovascular mortality was affected by increase of PM2.5 in Łomża (1.086, 1.020–1.156, p = 0.01) and Suwałki (1.085, 1.005–1.171, p = 0.04). PM2.5 had an influence on respiratory mortality in Łomża (1.163, 1.021–1.380, p = 0.03, lag 1). In the whole studied region, despite differences in the air quality, the influence of PMs on mortality was observed. [ABSTRACT FROM AUTHOR]

(1) Introduction: air pollution is considered to be one of the main risk factors for public health. According to the European Environment Agency (EEA), air pollution contributes to the premature deaths of approximately 500,000 citizens of the European Union (EU), including almost 5000 inhabitants of Poland every year. (2) Purpose: to assess the gender differences in the impact of air pollution on the mortality in the population of the city of Bialystok—the capital of the Green Lungs of Poland. (3) Materials and Methods: based on the data from the Central Statistical Office, the number—and causes of death—of Białystok residents in the period 2008–2017 were analyzed. The study utilized the data recorded by the Provincial Inspectorate for Environmental Protection station and the Institute of Meteorology and Water Management during the analysis period. Time series regression with Poisson distribution was used in statistical analysis. (4) Results: A total of 34,005 deaths had been recorded, in which women accounted for 47.5%. The proportion of cardiovascular-related deaths was 48% (n = 16,370). An increase of SO2 concentration by 1-µg/m3 (relative risk (RR) 1.07, 95% confidence interval (CI) 1.02–1.12; p = 0.005) and a 10 °C decrease of temperature (RR 1.03, 95% CI 1.01–1.05; p = 0.005) were related to an increase in the number of daily deaths. No gender differences in the impact of air pollution on mortality were observed. In the analysis of the subgroup of cardiovascular deaths, the main pollutant that was found to have an effect on daily mortality was particulate matter with a diameter of 2.5 μm or less (PM2.5); the RR for 10-µg/m3 increase of PM2.5 was 1.07 (95% CI 1.02–1.12; p = 0.01), and this effect was noted only in the male population. (5) Conclusions: air quality and atmospheric conditions had an impact on the mortality of Bialystok residents. The main air pollutant that influenced the mortality rate was SO2, and there were no gender differences in the impact of this pollutant. In the male population, an increased exposure to PM2.5 concentration was associated with significantly higher cardiovascular mortality. These findings suggest that improving air quality, in particular, even with lower SO2 levels than currently allowed by the World Health Organization (WHO) guidelines, may benefit public health. Further studies on this topic are needed, but our results bring questions whether the recommendations concerning acceptable concentrations of air pollutants should be stricter, or is there a safe concentration of SO2 in the air at all. [ABSTRACT FROM AUTHOR]

A case study of 74-year-old woman who was admitted to the hospital for issues regarding chest pain due to cardiac rupture. It mentions signs of cardiogenic shock such as skin pale and wet, blood pressure (BP) and heart rate (HR) undetectable shown by the patient. It also highlights treatment of the patient through takotsubo cardiomyopathy (TTC).

Families of deceased potential donors often object to organ harvesting on religious grounds. The aim of this study was to learn the attitudes and opinions of Judaism followers regarding organ donation. The study included 97 Judaism followers living in the northeastern part of Poland. The research used the diagnostic survey method. A fairly large percentage (approximately 92%) of respondents accepted treatment using organ transplantation. The removal of organs for transplantation from a loved one after his death was accepted by about 90%. After his death, 14.43% expressed opposition to organ removal. About one-third of respondents did not talk to the family about their organ donation attitude. The average age of people who talked to their family about their will to donate was 49.69 ± 13.95 years. In total, 91.75% of the respondents had a positive attitude toward organ transplantation, 6.19% negative, and 2.06% indifferent. According to respondents, the most common reasons for a family's refusal to collect organs from the deceased are death-related emotions (53.61%), religious beliefs (36.08%), and fear of misuse of organs (22.68%). Judaism believers mostly accept treatment with organs taken from living and deceased people. In a larger percentage, young people with higher and secondary education more often accepted organ donation. [ABSTRACT FROM AUTHOR]

Aim of the study: In the case of atherosclerosis, therapeutic management depends on the advancement of the disease. The ever-present element of management in each clinical form of the disease is conservative treatment, including e.g. the elimination of risk factors for sclerosis, pharmacological treatment, and the treatment of comorbidities. The aim of the work was to evaluate the lifestyles of patients with lower extremity arterial disease and the patients' expectations concerning health education referring to the disease and the recommended lifestyle. Material and methods: The respondent group was composed of 50 patients with lower extremity arterial disease, of both sexes (including 61% of males), aged from 24 to 89 years. The research was carried out at the Invasive Cardiology Clinic of University Clinical Hospital in Bialystok and at the Nursing Home in Bialystok. A self-constructed survey questionnaire (including 44 questions) was used. Results: Most of the patients did not observe the recommendations about reducing consumption of saturated fats and increasing the consumption of complex carbohydrates and dietary fibre. They did not exercise regularly, and nearly half of them smoked. Only 16% of the patients had normal BMI. The respondents wanted, among others, information on foot care, complications, symptoms, risk factors for the disease, pharmacological treatment, and rehabilitation methods. Conclusions: Because of the high percentage of atherosclerosis complications occurring in the investigated group of patients and their failure to observe doctors' orders concerning an appropriate lifestyle, special attention should be given to educating patients and motivating them to observe therapeutic recommendations regarding non-pharmacological treatment. [ABSTRACT FROM AUTHOR]

There is a lack of studies directly comparing the effect of air pollution on acute coronary syndrome (ACS) occurrence in industrial and non-industrial areas. A comparison of association of air pollution exposure with ACS in two cohorts of industrially different areas. The study covered 6,000,000 person-years of follow-up and five pollutants between 2008 and 2017. A time series regression analysis with 7-lag was used to assess the effects air pollution on ACS. A total of 9046 patients with ACS were included in the analysis, of whom 3895 (43.06%) had ST-elevation myocardial infarction (STEMI) - 45.39% from non-industrial area, and 42.37% from industrial area; and 5151 (56.94%) had non-ST-elevation myocardial infarction (NSTEMI) - 54.61% from non-industrial area and 57.63% from industrial area. The daily concentrations of PM 2.5 , PM 10 , NO 2 , SO 2 , CO were higher in industrial than in non-industrial area (P < 0.001). In non-industrial area, an increase of 10 μg/m3 of NO 2 concentration (Odds Ratio (OR) = 1.126, 95%CI = 1.009–1.257; P = 0.034, lag-0) and an increase of 1 mg/m3 in CO concentration (RR = 1.055, 95%CI = 1.010–1.103; P = 0.017, lag-0) were associated with an increase in the number of hospitalization due to NSTEMI (for industrial area increase of 10 μg/m3 in NO 2 (OR = 1.062, 95%CI = 1.020–1.094; P = 0.005, lag-0), SO 2 (OR = 1.061, 95%CI = 1.010–1.116; P = 0.018, lag-4), PM 10 (OR = 1.010, 95%CI = 1.001–1.030; P = 0.047, lag-6). In STEMI patients in industrial area, an increased hospitalization was found to be associated with an increase of 10 μg/m3 in SO 2 (OR = 1.094, 95%CI = 1.030–1.162; P = 0.002, lag-1), PM 2.5 (OR = 1.041, 95%CI = 1.020–1.073; P < 0.001, lag-1), PM 10 (OR = 1.030, 95%CI = 1.010–1.051; P < 0.001, lag-1). No effects of air pollution on the number of hospitalization due to STEMI were noted from non-industrial area. The risk of air pollution-related ACS was higher in industrial over non-industrial area. The effect of NO 2 on the incidence of NSTEMI was observed in both areas. In industrial area, the effect of PMs and SO 2 on NSTEMI and STEMI were also observed. A clinical effect was more delayed in time in patients with NSTEMI, especially after exposure to PM 10. Chronic exposure to air pollution may underlie the differences in the short-term effect between particulate air pollution impact on the incidence of STEMI. [Display omitted] • The first study with 6,000,000 person-years and seven-lag design in central Europe. • Comparison of pollution impact on ACS in areas of notably different air quality. • Short-term exposure to NO 2 influenced the prevalence of ACS in both areas. • In severely polluted area concentrations of PMs, SO 2 , NO 2 affected STEMI and NSTEMI. • No effect of air pollution on STEMI was noted in non-industrial area. [ABSTRACT FROM AUTHOR]