Association of ambient PM and PM with coronary stenosis measured using selective coronary angiography.

Background: Long-term ambient particulate matter (PM) exposure exerts detrimental effects on cardiovascular health. Evidence on the relation of chronically exposed ambient PM and PM with coronary stenosis remains lacking. Our aim was to investigate the association of PM and PM with coronary stenosis in patients undergoing coronary angiography.

Methods: We performed a retrospective cohort study consisting of 7513 individuals who underwent coronary angiography in Fujian Province, China, from January 2019 to December 2021. We calculated a modified Gensini score (GS) to represent the degree of stenosis in coronary arteries by selective coronary angiography. We fitted linear regressions and logistic models to assess the association of PM and PM with coronary stenosis. We employed restricted cubic splines to describe the exposure-response curves. We performed mediation analyses to assess the potential mediators.

Results: Long-term ambient PM and PM (prior three years average) exposure was significantly associated with the GS, with a breakpoint concentration of 47.5 μg/m and 25.8 μg/m for PM and PM, respectively, above which we found a linear positive exposure-response relationship of ambient PM with GS. Each 10 µg /m increase in PM exposure (β: 4.81, 95 % CI: 0.44-9.19) and PM exposure [β: 10.50, 95 % CI: 3.14-17.86] were positively related to the GS. The adjusted odds ratio (OR) for each 10 µg/m increment in PM exposure on severe coronary stenosis was 1.33 (95 % CI: 1.04-1.76). Correspondingly, the adjusted OR for PM was 1.87 (95 % CI: 1.24-2.99). The mediation analysis indicated that the effect of PM on coronary stenosis may be partially mediated through total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, serum creatinine and blood urea nitrogen, and the effect of PM may be mediated in part by hemoglobin A1c.

Conclusion: Our study provides the first evidence that chronic ambient PM and PM exposure was associated with coronary stenosis assessed by GS in patients with suspected coronary artery disease and reveals its potential mediators.