Association between satellite-based estimates of long-term PM2.5 exposure and coronary artery disease

Abstract

Background: Epidemiological studies have identified associations between long-term PM2.5 exposure and cardiovascular events, though most have relied on concentrations from central-site air quality monitors.

Methods: We utilized a cohort of 5679 patients who had undergone cardiac catheterization at Duke University between 2002-2009 and resided in North Carolina. We used estimates of daily PM2.5 concentrations for North Carolina during the study period based on satellite derived Aerosol Optical Depth (AOD) measurements and PM2.5 concentrations from ground monitors, which were spatially resolved with a 10×10km resolution, matched to each patient's residential address and averaged for the year prior to catheterization. The Coronary Artery Disease (CAD) index was used to measure severity of CAD; scores >23 represent a hemodynamically significant coronary artery lesion in at least one major coronary vessel. Logistic regression modeled odds of having CAD or an MI with each 1μg/m(3) increase in annual average PM2.5, adjusting for sex, race, smoking status and socioeconomic status.

Results: In adjusted models, a 1μg/m(3) increase in annual average PM2.5 was associated with an 11.1% relative increase in the odds of significant CAD (95% CI: 4.0-18.6%) and a 14.2% increase in the odds of having a myocardial infarction (MI) within a year prior (95% CI: 3.7-25.8%).

Conclusions: Satellite-based estimates of long-term PM2.5 exposure were associated with both coronary artery disease (CAD) and incidence of myocardial infarction (MI) in a cohort of cardiac catheterization patients.

Keywords: Coronary disease; Epidemiology; Myocardial infarction; PM(2.5); Spatiotemporal analyses.

Figure 1

Residential location of CATHGEN participants.

Figure 2

Annual average PM_2.5 (μg/m³) predictions averaged from 2002 to 2009. Dots represent EPA PM_2.5 monitoring stations.