Elemental carbon exposure at residence and survival after acute myocardial infarction

Stephanie Von Klot, Alexandros Gryparis, Cathryn Tonne, Jeffrey Yanosky, Brent A. Coull, Robert J. Goldberg, Darleen Lessard, Steven J. Melly, Helen H. Suh, Joel Schwartz

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24 Scopus citations

Abstract

Background: Particulate air pollution has been consistently related to cardiovascular mortality. Some evidence suggests that particulate matter may accelerate the atherosclerotic process. Effects of within-city variations of particulate air pollution on survival after an acute cardiovascular event have been little explored. Methods: We conducted a cohort study of hospital survivors of acute myocardial infarction (MI) from the Worcester, MA, metropolitan area to investigate the long-term effects of within-city variation in traffic-related air pollution on mortality. The study builds on an ongoing community-wide investigation examining changes over time in Mi incidence and case-fatality rates. We included confirmed cases of MI in 1995, 1997, 1999, 2001, and 2003. Long-term survival status was ascertained through 2005. A validated spatiotemporal land use regression model for traffic-related air pollution was developed and annual averages of elemental carbon at residence estimated. The effect of estimated elemental carbon on the long-term mortality of patients discharged after Mi was analyzed using a cox proportional hazards model, controlling for a variety of demographic, medical history, and clinical variables Results: Of the 3895 patients with validated MI, 44% died during follow-up. Exposure to estimated elemental carbon in the year of entry into the study was 0.44 μ g/m 3 on average. All-cause mortality increased by 15% (95% confidence interval = 0.03%-29%) per interquartile range increase in estimated yearly elemental carbon (0.24 μ g/m 3) after the second year of survival. No association.

Original languageEnglish (US)
Pages (from-to)547-554
Number of pages8
JournalEpidemiology
Volume20
Issue number4
DOIs
StatePublished - Jul 1 2009

All Science Journal Classification (ASJC) codes

  • Epidemiology

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    Von Klot, S., Gryparis, A., Tonne, C., Yanosky, J., Coull, B. A., Goldberg, R. J., Lessard, D., Melly, S. J., Suh, H. H., & Schwartz, J. (2009). Elemental carbon exposure at residence and survival after acute myocardial infarction. Epidemiology, 20(4), 547-554. https://doi.org/10.1097/EDE.0b013e31819d9501