Abstract
Background
We investigated the change of coronary atherosclerosis with long-term exposure to
fine particulate matter of aerodynamic diameter <2.5 μm (PM2.5) using coronary computed tomography angiography (CCTA).
Methods
Subjects undergoing serial CCTAs between January 2007 and December 2017 (n = 3,127)
were analyzed. Each individual's cumulative amount of PM2.5 exposure between the two CCTAs was evaluated by Kriging interpolation and zonal analysis,
considering the time interval between the two CCTAs. The main outcome was progression
of coronary artery calcium (CAC) with additional semiquantitative analysis on the
changes in the severity and composition of atherosclerotic plaques.
Results
The CAC scores increased by 30.8 Agatston units per-year under a median PM2.5 concentration 24.9 μg/m3 and tended to increase with the cumulative amount of PM2.5 exposure (r = 0.321, p <0.001). The CAC progressed in 1,361 (43.5%) subjects during a median 53 months
follow-up. The cumulative amount of PM2.5 exposure was independently associated with CAC progression (adjusted OR 1.09, p <0.001). By random forest analysis, the relative impact of cumulative amount of
PM2.5 exposure on CAC progression was higher than that of traditional cardiovascular risk
factors and the average concentration of PM2.5. The extent of coronary atherosclerosis and newly developed calcified plaque on follow-up
were also significantly associated with the cumulative amount of PM2.5 exposure.
Conclusions
Cumulative exposure to air pollution is associated with the progression of diffuse
coronary calcification, the importance of which may be more significant than other
traditional cardiovascular risk factors. Further investigations into the causality
between PM2.5 and coronary atherosclerosis are warranted to improve global cardiovascular health.
Graphical abstract
Graphical Abstract
Keywords
Abbreviations:
AAP (ambient air pollution), CAC (coronary artery calcification), CACS (coronary artery calcium score), CAD (coronary artery disease), CCTA (coronary computed tomography angiography), CVD (cardiovascular disease), OR (odds ratio), PM2.5 (fine particulate matter of an aerodynamic diameter <2.5 μm)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 23, 2021
Accepted:
November 8,
2021
Received in revised form:
October 15,
2021
Received:
September 2,
2021
Identification
Copyright
© 2021 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.
