%0 Journal Article
%T Air Pollution and Adverse Cardiovascular Events After Coronary Artery Bypass Grafting: A 10-Year Nationwide Study.
%A Deo SV
%A Elgudin Y
%A Motairek I
%A Ho F
%A Brook RD
%A Su J
%A Fremes S
%A deSouza P
%A Hahad O
%A Rajagopalan S
%A Al-Kindi S
%J JACC Adv
%V 3
%N 2
%D 2024 Feb
%M 38939372
暂无%R 10.1016/j.jacadv.2023.100781
%X <B>UNASSIGNED: </B>Increased particulate matter <2.5 μm (PM2.5) air pollution is associated with adverse cardiovascular outcomes. However, its impact on patients with prior coronary artery bypass grafting (CABG) is unknown.<BR><B>UNASSIGNED: </B>The purpose of this study was to evaluate the association between major adverse cardiovascular events (MACE) (defined as myocardial infarction, stroke, or cardiovascular death) and air pollution after CABG.<BR><B>UNASSIGNED: </B>We linked 26,403 U.S. veterans who underwent CABG (2010-2019) nationally with average annual ambient PM2.5 estimates using residential address. Over a 5-year median follow-up period, we identified MACE and fit a multivariable Cox proportional hazard model to determine the risk of MACE as per PM2.5 exposure. We also estimated the absolute potential reduction in PM2.5 attributable MACE simulating a hypothetical PM2.5 lowered to the revised World Health Organization standard of 5 μg/m3.<BR><B>UNASSIGNED: </B>The observed median PM2.5 exposure was 7.9 μg/m3 (IQR: 7.0-8.9 μg/m3; 95% of patients were exposed to PM2.5 above 5 μg/m3). Increased PM2.5 exposure was associated with a higher 10-year MACE rate (first tertile 38% vs third tertile 45%; P < 0.001). Adjusting for demographic, racial, and clinical characteristics, a 10 μg/m3 increase in PM2.5 resulted in 27% relative risk for MACE (HR: 1.27, 95% CI: 1.10-1.46; P < 0.001). Currently, 10% of total MACE is attributable to PM2.5 exposure. Reducing maximum PM2.5 to 5 μg/m3 could result in a 7% absolute reduction in 10-year MACE rates.<BR><B>UNASSIGNED: </B>In this large nationwide CABG cohort, ambient PM2.5 air pollution was strongly associated with adverse 10-year cardiovascular outcomes. Reducing levels to World Health Organization-recommended standards would result in a substantial risk reduction at the population level.