A time-to-event analysis on air pollutants with the risk of cardiovascular disease and mortality: A systematic review and meta-analysis of 84 cohort studies

Raymond Pranata, Rachel Vania, Alexander Edo Tondas, Budhi Setianto, Anwar Santoso

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Objective: Air pollution is one of the most substantial problems globally. Aerodynamic toxic of particulate matter with <10 mm in diameter (PM10), or <2.5 mm (PM2.5), as well as nitric dioxide (NO2), have been linked with health issues. We aimed to perform a comprehensive analysis of the time-to-event for different types of air pollutants on cardiovascular disease (CVD) events based on cohort studies. Methods: A comprehensive search on topics that assesses air pollution and cardiovascular disease with keywords up until July 2019 was performed. Results: There were a total of 28 215 394 subjects from 84 cohorts. Increased PM2.5 was associated with composite CVD [HR 1.10 (1.02, 1.19)], acute coronary events [HR 1.15 (1.12, 1.17)], stroke [HR 1.13 (1.06, 1.19)], and hypertension [HR 1.07 (1.01, 1.14)], all-cause mortality [HR 1.07 (1.04, 1.09)], CVD mortality [HR 1.10 (1.07, 1.12)], and ischemic heart disease (IHD) mortality [HR 1.11 (1.07, 1.16)]. Association with AF became significant after removal of a study. Increased PM10 was associated with heart failure [HR 1.25 (1.04, 1.50)], all-cause mortality [HR 1.16 (1.06, 1.27)], CVD mortality [HR 1.17 (1.04, 1.30)], and IHD mortality [HR 1.03 (1.01, 1.05)]. Increased of NO2 was associated with increased composite CVD [HR 1.15 (1.02, 1.29)], atrial fibrillation [HR 1.01 (1.01, 1.02)], acute coronary events [HR 1.08 (1.02, 1.13)], all-cause mortality [HR 1.23 (1.14, 1.32)], CVD mortality [HR 1.17 (1.10, 1.25)], and IHD mortality [HR 1.05 (1.03, 1.08)]. Conclusion: Air pollutants are associated with an increased incidence of cardiovascular diseases, all-cause mortality, and CVD mortality.

Original languageEnglish
JournalJournal of Evidence-Based Medicine
DOIs
Publication statusAccepted/In press - 1 Jan 2020

Keywords

  • air pollution
  • cardiovascular disease
  • heart failure
  • mortality
  • stroke

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