Long-Term Exposure to Ambient Air Pollution and Myocardial Infarction: A Systematic Review and Meta-Analysis

Li Zou; Qiao Zong; Wenning Fu; Zeyu Zhang; Hongbin Xu; Shijiao Yan; Jin Mao; Yan Zhang; Shiyi Cao; Chuanzhu Lv

doi:10.3389/fmed.2021.616355

Long-Term Exposure to Ambient Air Pollution and Myocardial Infarction: A Systematic Review and Meta-Analysis

Front Med (Lausanne). 2021 Mar 17:8:616355. doi: 10.3389/fmed.2021.616355. eCollection 2021.

Authors

Li Zou^{1

2}, Qiao Zong³, Wenning Fu^{4

5}, Zeyu Zhang¹, Hongbin Xu³, Shijiao Yan^{2

6}, Jin Mao⁴, Yan Zhang⁷, Shiyi Cao³, Chuanzhu Lv^{5

8

9

10}

Affiliations

¹ Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, China.
² Department of Neurology, Taihe Hospital, Hubei University of Medicine, Shiyan, China.
³ School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁴ School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁵ Key Laboratory of Emergency and Trauma, Ministry of Education, College of Emergency and Trauma, Hainan Medical University, Haikou, China.
⁶ School of International Education, Hainan Medical University, Haikou, China.
⁷ School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
⁸ Department of Emergency, Hainan Clinical Research Center for Acute and Critical Diseases, The Second Affiliated Hospital of Hainan Medical University, Haikou, China.
⁹ Emergency and Trauma College, Hainan Medical University, Haikou, China.
¹⁰ Research Unit of Island Emergency Medicine, Medical University, Chinese Academy of Medical Sciences, Haikou, China.

Abstract

Background and Objective: An increasing number of epidemiological original studies suggested that long-term exposure to particulate matter (PM_2.5 and PM₁₀) could be associated with the risk of myocardial infarction (MI), but the results were inconsistent. We aimed to synthesized available cohort studies to identify the association between ambient air pollution (PM_2.5 and PM₁₀) and MI risk by a meta-analysis. Methods: PubMed and Embase were searched through September 2019 to identify studies that met predetermined inclusion criteria. Reference lists from retrieved articles were also reviewed. A random-effects model was used to calculate the pooled relative risk (RR) and 95% confidence intervals (CI). Results: Twenty-seven cohort studies involving 6,764,987 participants and 94,540 patients with MI were included in this systematic review. The pooled results showed that higher levels of ambient air pollution (PM_2.5 and PM₁₀) exposure were significantly associated with the risk of MI. The pooled relative risk (RR) for each 10-μg/m³ increment in PM_2.5 and PM₁₀ were 1.18 (95% CI: 1.11-1.26), and 1.03 (95% CI: 1.00-1.05), respectively. Exclusion of any single study did not materially alter the combined risk estimate. Conclusions: Integrated evidence from cohort studies supports the hypothesis that long-term exposure to PM_2.5 and PM₁₀ is a risk factor for MI.

Keywords: PM10; PM2.5 (AQI); air pollution; meta-analysis; myocardial infarction; particulate matter.

Publication types

Systematic Review