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- Title
Particulate Air Pollution, Progression, and Survival after Myocardial Infarction.
- Authors
Zanobetti, Antonella; Schwartz, Joel
- Abstract
Several studies have examined the effect of particulate pollution (PM) on survival in general populations, but less is known about susceptible groups. Moreover, previous cohort studies have been cross-sectional and subject to confounding by uncontrolled differences between cities. DESIGN: We investigated whether PM was associated with progression of disease or reduced survival in a study of 196,000 persons from 21 U.S. cities discharged alive following an acute myocardial infarction (MI), using within-city between-year exposure to PM. We constructed city-specific cohorts of survivors of acute MI using Medicare data between 1985 and 1999, and defined three outcomes on follow-up: death, subsequent MI, and a first admission for congestive heart failure (CHF). Yearly averages of PM10 (particulate matter with aerodynamic diameter < 10 µm) were merged to the individual annual follow-up in each city. We applied Cox's proportional hazard regression model in each city, with adjustment for individual risk factors. In the second stage of the analysis, the city-specific results were combined using a meta-regression. RESULTS: We found significant associations with a hazard ratio for the sum of the distributed lags of 1.3 [95% confidence interval (CI), 1.2-1.5] for mortality, a hazard ratio of 1.4 (95% CI, 1.2-1.7) for a hospitalization for CHF, and a hazard ratio of 1.4 (95% CI, 1.1-1.8) for a new hospitalization for MI per 10 µg/m³ PM10. CONCLUSIONS: This is the first long-term study showing a significant association between particle exposure and adverse post-MI outcomes in persons who survived an MI.
- Subjects
EPIDEMIOLOGY; PUBLIC health; INFECTIOUS disease transmission; MYOCARDIAL infarction; PARTICULATE matter; AIR pollution; HEART diseases &; the environment; AIR quality; STATISTICAL hypothesis testing
- Publication
Environmental Health Perspectives, 2007, Vol 115, Issue 5, p769
- ISSN
0091-6765
- Publication type
Article
- DOI
10.1289/ehp.9201