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TOPLINE:
Patients with valvular heart disease who had higher monthly exposure to fine particulate matter with a diameter < 2.5 µm (PM2.5) had a greater risk for all-cause mortality and hospitalization for heart failure than those with lower exposure.
METHODOLOGY:
- Researchers analyzed data from a prospective cohort study to assess whether higher ambient exposure to PM2.5 was associated with worse outcomes in patients with moderate or severe valvular heart disease.
- They included 12,258 patients with valvular heart disease from a multicenter Chinese registry between April and June 2018; the mean age of the patients was 61.25 years, and 54.75% were men.
- Monthly ground-level PM2.5 concentrations were estimated using a high-quality dataset combining satellite and ground monitor data and mapped to each patient’s home address. Patients were categorized into low, medium, and high tertiles of exposure.
- The primary endpoint was a composite of all-cause mortality and hospitalization for heart failure. Secondary endpoints included myocardial infarction and stroke.
- Researchers followed patients for a median of 2.02 years, recording outcomes every 6 months via clinic visits or telephone interviews until death, hospitalization, or the end of the study.
TAKEAWAY:
- Overall, 1577 patients (12.9%) experienced the primary endpoint.
- Patients in the highest tertile of monthly ambient exposure to PM2.5 had a 24% higher risk for the primary endpoint than those in the lowest tertile after full adjustment (P for trend = .004).
- Each IQR (21.8 µg/m3) increase in monthly ambient exposure to PM2.5 was associated with an 11% increase in the risk of experiencing the primary endpoint (P < .001).
- Patients in the highest vs lowest tertile of monthly ambient exposure to PM2.5 had a 27% higher risk for all-cause mortality (P for trend = .009) and a 29% higher risk for hospitalization for heart failure (P for trend = .041).
IN PRACTICE:
“In high-burden regions, mitigation of air pollution exposure may represent a complementary strategy to optimize outcomes alongside surgical and transcatheter interventions. Furthermore, recognition of environmental determinants could inform patient counselling and guide follow-up strategies in susceptible individuals. Third, lifestyle modifications such as reducing outdoor activities during high-pollution days or using indoor air filtration systems may serve as practical preventive strategies,” the researchers wrote.
SOURCE:
This study was led by Xiangming Hu of Southern Medical University in Guangzhou, China. It was published online on May 18 in Heart.
LIMITATIONS:
This study was observational; thus, it could not prove cause and effect. Researchers lacked information on weather, socioeconomic status, and lifestyle. Exposure was assigned from baseline home addresses, which may have changed over the study period.
DISCLOSURES:
This study received support from the CAMS Innovation Fund for Medical Sciences, Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences, and the Beijing Natural Science Foundation. The authors did not declare any conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
