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Short-term air pollution exposure and mechanisms of plaque instability in acute coronary syndromes: An optical coherence tomography study.
- Source :
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Atherosclerosis [Atherosclerosis] 2024 Mar; Vol. 390, pp. 117393. Date of Electronic Publication: 2023 Nov 24. - Publication Year :
- 2024
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Abstract
- Background and Aims: Air pollution is emerging as an important risk factor for acute coronary syndrome (ACS). In this study, we investigated the association between short-term air pollution exposure and mechanisms of coronary plaque instability evaluated by optical coherence tomography (OCT) imaging in ACS patients.<br />Methods: Patients with ACS undergoing OCT imaging were retrospectively selected. Mechanism of culprit lesion instability was classified as plaque rupture (PR) or intact fibrous cap (IFC) by OCT. Based on each case's home address, the mean daily exposures to several pollutants, including particulate matter 2.5 (PM <subscript>2.5</subscript> ), on the same day of ACS and in the immediate days (up to 6 days) prior to the index ACS, were collected.<br />Results: 139 ACS patients were included [69 (49.6%) had PR and 70 (50.4%) IFC]. Patients with PR, compared to those with IFC, had higher PM <subscript>2.5</subscript> exposure levels on the same day of ACS, without differences in the immediate 6 days before index ACS. At multivariate analysis, PM <subscript>2.5</subscript> exposure on the same day of ACS was the only independent predictor of PR [OR = 1.912 per SD (8.6 μg/m <superscript>3</superscript> ), CI95 % (1.087-3.364), p = 0.025]. Patients with PR presented a steady increase in PM <subscript>2.5</subscript> daily exposure levels in the days preceding the occurrence of ACS, with a peak the day of ACS (p for trend = 0.042) CONCLUSIONS: This study demonstrates for the first time that a higher short-term PM2.5 exposure, on the same day of ACS, is associated with an increased risk of PR as a pathobiological mechanism of coronary plaque instability.<br />Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.<br /> (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Humans
Tomography, Optical Coherence methods
Retrospective Studies
Rupture, Spontaneous complications
Rupture, Spontaneous pathology
Fibrosis
Particulate Matter adverse effects
Coronary Vessels diagnostic imaging
Coronary Vessels pathology
Coronary Angiography methods
Acute Coronary Syndrome diagnostic imaging
Acute Coronary Syndrome etiology
Acute Coronary Syndrome epidemiology
Plaque, Atherosclerotic complications
Subjects
Details
- Language :
- English
- ISSN :
- 1879-1484
- Volume :
- 390
- Database :
- MEDLINE
- Journal :
- Atherosclerosis
- Publication Type :
- Academic Journal
- Accession number :
- 38061973
- Full Text :
- https://doi.org/10.1016/j.atherosclerosis.2023.117393