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Cumulative exposure amount of PM2.5 in the ambient air is associated with coronary atherosclerosis - Serial coronary CT angiography study
Affiliation:1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, South Korea;2. Healthcare System Gangnam Center, Seoul National University Hospital, Seoul, South Korea;3. Department of Internal Medicine, Yonsei Health Promotion Internal Clinic, Seoul, South Korea;4. Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine and Cardiovascular Center, Yongin, Gyeonggi-do, South Korea;5. Department of Family Medicine, Health Promotion Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;6. Department of Cardiology and Cardiovascular Center, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;7. Institute of Health and Environment, Seoul National University, Seoul, South Korea;8. Department of Preventive Medicine, College of Medicine, Seoul National University, Seoul, South Korea;9. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;10. Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea;1. Department of Cardiovascular Radiology & Endovascular Interventions, All India Institute of Medical Sciences, New Delhi, 110029, India;2. Department of Cardiology, All India Institute of Medical Sciences, New Delhi, 110029, India;1. Centro Cardiologico Monzino, IRCCS, Milan, Italy;2. Department of Biomedical Sciences for Health, University of Milan, Milan, Italy;3. Biosense Webster, Johnson & Johnson Medical S.p.A, Italy;4. Department of Biomedical, Surgical and Dental Sciences, University of Milan, Milan, Italy;5. Department of Biomedical and Clinical Sciences “Luigi Sacco”, University of Milan, Milan, Italy;1. Medical University of South Carolina, Department of Radiology and Radiological Science, USA;2. Siemens Healthineers, Princeton, NJ, USA;3. Siemens Healthineers, Malver, PA, USA;4. Johns Hopkins Hospital, Department of Radiology and Radiological Science, USA;5. Medical University of South Carolina, Department of Medicine, USA;6. Baylor College of Medicine, Department of Medicine, USA;1. Division of Cardiology, Department of Internal Medicine, Città della Salute e della Scienza, University of Turin, Turin, Italy;2. Radiology Unit, Department of Surgical Sciences, Città della Salute e della Scienza, Turin, Italy;3. Division of Cardiac Surgery, Department of Surgery, Città della Salute e della Scienza, Turin, Italy;1. Department of Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan;2. Keio University School of Medicine, Clinical and Translational Research Center, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan;3. Yokohama City University School of Data Science, 22-2, Seto, Kanazawa, Yokohama, Kanagawa, 236-0027, Japan;4. HIMEDIC Imaging Center at Lake Yamanaka, XIV Yamanakako B2F, 562-12 Hirano, Yamanashi, 401-0502, Japan
Abstract:BackgroundWe investigated the change of coronary atherosclerosis with long-term exposure to fine particulate matter of aerodynamic diameter <2.5 ?μm (PM2.5) using coronary computed tomography angiography (CCTA).MethodsSubjects undergoing serial CCTAs between January 2007 and December 2017 (n ?= ?3,127) were analyzed. Each individual's cumulative amount of PM2.5 exposure between the two CCTAs was evaluated by Kriging interpolation and zonal analysis, considering the time interval between the two CCTAs. The main outcome was progression of coronary artery calcium (CAC) with additional semiquantitative analysis on the changes in the severity and composition of atherosclerotic plaques.ResultsThe CAC scores increased by 30.8 Agatston units per-year under a median PM2.5 concentration 24.9 ?μg/m3 and tended to increase with the cumulative amount of PM2.5 exposure (r ?= ?0.321, p ?<0.001). The CAC progressed in 1,361 (43.5%) subjects during a median 53 months follow-up. The cumulative amount of PM2.5 exposure was independently associated with CAC progression (adjusted OR 1.09, p ?<0.001). By random forest analysis, the relative impact of cumulative amount of PM2.5 exposure on CAC progression was higher than that of traditional cardiovascular risk factors and the average concentration of PM2.5. The extent of coronary atherosclerosis and newly developed calcified plaque on follow-up were also significantly associated with the cumulative amount of PM2.5 exposure.ConclusionsCumulative exposure to air pollution is associated with the progression of diffuse coronary calcification, the importance of which may be more significant than other traditional cardiovascular risk factors. Further investigations into the causality between PM2.5 and coronary atherosclerosis are warranted to improve global cardiovascular health.
Keywords:Air pollution  Particulate matter  Ambient  Coronary computed tomography angiography  Coronary artery disease  AAP"}  {"#name":"keyword"  "$":{"id":"kwrd0040"}  "$$":[{"#name":"text"  "_":"ambient air pollution  CAC"}  {"#name":"keyword"  "$":{"id":"kwrd0050"}  "$$":[{"#name":"text"  "_":"coronary artery calcification  CACS"}  {"#name":"keyword"  "$":{"id":"kwrd0060"}  "$$":[{"#name":"text"  "_":"coronary artery calcium score  CAD"}  {"#name":"keyword"  "$":{"id":"kwrd0070"}  "$$":[{"#name":"text"  "_":"coronary artery disease  CCTA"}  {"#name":"keyword"  "$":{"id":"kwrd0080"}  "$$":[{"#name":"text"  "_":"coronary computed tomography angiography  CVD"}  {"#name":"keyword"  "$":{"id":"kwrd0090"}  "$$":[{"#name":"text"  "_":"cardiovascular disease  OR"}  {"#name":"keyword"  "$":{"id":"kwrd0100"}  "$$":[{"#name":"text"  "_":"odds ratio  fine particulate matter of an aerodynamic diameter <2  5 ?μm
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