The relationship between increased air pollution expressed as PM₁₀ concentration and the frequency of percutaneous coronary interventions in patients with acute coronary syndromes—a seasonal differences

The aim of the presented study was to assess the relationship between air pollution expressed as particulate air matters less than 10 μm (PM₁₀) and acute coronary syndromes (ACSs). In this observational study, we selected regions with low pollution according to PM₁₀ (non-polluted) and with the highest pollution (polluted). The occurrence of percutaneous coronary interventions (PCIs) in patients with ACSs was matched according to the location. The current study included 7678 patients in polluted areas and 4327 patients from non-polluted regions. Analysing the period from January to December 2017, the number of patients undergoing angioplasty in monitored catheterization laboratories and the mean daily concentration of PM₁₀ in all selected cities were calculated for each day. The annual average concentration of PM₁₀ amounts to 50.95 μg/m³ in polluted and 26.62 μg/m³ in non-polluted cities (P < 0.01). The rise in PM₁₀ pollution levels was related with the increased frequency of PCIs in patients with ACSs in polluted (P < 0.01) and non-polluted (P < 0.01) areas. In the non-polluted regions, the increase in PM₁₀ concentration by every 1 μg/m³ causes 0.22 additional ACS angioplasties per week. In polluted regions, the same increase in PM₁₀ concentration causes 0.18 additional ACS angioplasties per week. In non-winter weeks, the mean number of ACS PCIs expressed in promiles was lower than in winter weeks in polluted (P = 0.03) and non-polluted cities (P = 0.02). The study shows that the increase in air pollution expressed as PM₁₀ concentration and winter time influences the frequency of ACS-related PCIs.