Impacto de la contaminación atmosférica sobre la inflamación, el estrés oxidativo y el pronóstico a un año en pacientes ingresados por síndrome isquémico coronario agudo: diseño del estudio AIRACOS

Saharan Dust Events in the Dust Belt -Canary Islands- and the Observed Association with in-Hospital Mortality of Patients with Heart Failure

Recent studies have found increases in the cardiovascular mortality rates during poor air quality events due to outbreaks of desert dust. In Tenerife, we collected (2014–2017) data in 829 patients admitted with a heart failure diagnosis in the Emergency Department of the University Hospital of the Canaries. In this region, concentrations of PM₁₀ and PM_2.5 are usually low (~20 and 10 µg/m³), but they increase to 360 and 115 μg/m³, respectively, during Saharan dust events. By using statistical tools (including multivariable logistic regressions), we compared in-hospital mortality of patients with heart failure and exposure to PM₁₀ and PM_2.5 during dust and no-dust events. We found that 86% of in-hospital heart failure mortality cases occurred during Saharan dust episodes that resulted in PM₁₀ > 50 µg/m³ (interquartile range: 71–96 µg/m³). A multivariate analysis showed that, after adjusting for other covariates, exposure to Saharan dust events associated with PM₁₀ > 50 µg/m³ was an independent predictor of heart failure in-hospital mortality (OR = 2.79, 95% CI (1.066–7.332), p = 0.03). In conclusion, this study demonstrates that exposure to high Saharan dust concentrations is independently associated with in-hospital mortality in patients with heart failure.

Short-term effects of air pollution, markers of endothelial activation, and coagulation to predict major adverse cardiovascular events in patients with acute coronary syndrome: insights from AIRACOS study

The aim of this study was to determine whether markers of inflammation and coagulation are associated with short-term particulate matter exposure and predict major adverse cardiovascular events at 360 d in patients with acute coronary syndrome (ACS). We included 307 consecutive patients, and assessed the average concentrations of data on atmospheric pollution in ambient air and meteorological variables from 1 d up to 7 d prior to admission. In patients with ACS, the markers of endothelial activation and coagulation, but not black carbon exposure, are associated with major adverse cardiovascular events at one-year follow-up.

Influence of meteorological conditions on hospital admission in patients with acute coronary syndrome with and without ST-segment elevation: Results of the AIRACOS study

OBJECTIVE

Evaluate whether the meterological parameters affecting revenues in patients with ST-segment and non-ST-segment elevation ACS.

DESIGN

A prospective cohort study was carried out.

SETTING

Coronary Care Unit of Hospital Universitario de Canarias

PATIENTS

We studies a total of 307 consecutive patients with a diagnosis of ST-segment and non-ST-segment elevation ACS. We analyze the average concentrations of particulate smaller than 10 and 2.5μm diameter, particulate black carbon, the concentrations of gaseous pollutants and meteorological parameters (wind speed, temperature, relative humidity and atmospheric pressure) that were exposed patients from one day up to 7 days prior to admission.

INTERVENTIONS

None.

VARIABLES OF INTEREST

Demographic, clinical, atmospheric particles, concentrations of gaseous pollutants and meterological parameters.

RESULTS

A total of 138 (45%) patients were classified as ST-segment and 169 (55%) as non-ST-segment elevation ACS. No statistically significant differences in exposure to atmospheric particles in both groups. Regarding meteorological data, we did not find statistically significant differences, except for higher atmospheric pressure in ST-segment elevation ACS (999.6±2.6 vs. 998.8±2.5 mbar, P=.008). Multivariate analysis showed that atmospheric pressure was significant predictor of ST-segment elevation ACS presentation (OR: 1.14, 95% CI: 1.04-1.24, P=.004).

CONCLUSIONS

In the patients who suffer ACS, the presence of higher number of atmospheric pressure during the week before the event increase the risk that the ST-segment elevation ACS.