Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

Long-term ambient air pollution and coronary atherosclerosis : Results from the Swedish SCAPIS study

Kilbo Edlund, Karl ; Andersson, Eva M. ; Asker, Christian ; Barregard, Lars ; Bergström, Göran ; Eneroth, Kristina ; Jernberg, Tomas ; Ljunggren, Stefan ; Molnár, Peter and Sommar, Johan Nilsson , et al. (2024) In Atherosclerosis
Abstract

Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis. Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address... (More)

Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis. Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM2.5), <10 μm (PM10), and nitrogen oxides (NOx) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders. Results: Median 10-year average PM2.5 exposure was 6.2 μg/m3 (range 3.5–13.4 μg/m3). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM2.5 was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m3). Associations with significant stenoses were inconsistent. Conclusions: In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM2.5 appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; ; ; ; ; ; and , et al. (More)
; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; ; and (Less)
organization
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
Air pollution, Atherosclerosis, Cardiovascular diseases, Coronary artery disease, Nitrogen oxides, Particulate matter
in
Atherosclerosis
article number
117576
publisher
Elsevier
external identifiers
  • scopus:85193925845
  • pmid:38797616
ISSN
0021-9150
DOI
10.1016/j.atherosclerosis.2024.117576
language
English
LU publication?
yes
id
5e4dcb1e-0fc2-4eec-80e0-bfbe116b3735
date added to LUP
2024-06-19 14:47:44
date last changed
2024-06-20 03:00:05
@article{5e4dcb1e-0fc2-4eec-80e0-bfbe116b3735,
  abstract     = {{<p>Background and aims: Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis. Methods: We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter &lt;2.5 μm (PM<sub>2.5</sub>), &lt;10 μm (PM<sub>10</sub>), and nitrogen oxides (NO<sub>x</sub>) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders. Results: Median 10-year average PM<sub>2.5</sub> exposure was 6.2 μg/m<sup>3</sup> (range 3.5–13.4 μg/m<sup>3</sup>). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM<sub>2.5</sub> was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m<sup>3</sup>). Associations with significant stenoses were inconsistent. Conclusions: In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM<sub>2.5</sub> appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.</p>}},
  author       = {{Kilbo Edlund, Karl and Andersson, Eva M. and Asker, Christian and Barregard, Lars and Bergström, Göran and Eneroth, Kristina and Jernberg, Tomas and Ljunggren, Stefan and Molnár, Peter and Sommar, Johan Nilsson and Oudin, Anna and Pershagen, Göran and Persson, Åsa and Pyko, Andrei and Spanne, Mårten and Tondel, Martin and Ögren, Mikael and Ljungman, Petter and Stockfelt, Leo}},
  issn         = {{0021-9150}},
  keywords     = {{Air pollution; Atherosclerosis; Cardiovascular diseases; Coronary artery disease; Nitrogen oxides; Particulate matter}},
  language     = {{eng}},
  publisher    = {{Elsevier}},
  series       = {{Atherosclerosis}},
  title        = {{Long-term ambient air pollution and coronary atherosclerosis : Results from the Swedish SCAPIS study}},
  url          = {{http://dx.doi.org/10.1016/j.atherosclerosis.2024.117576}},
  doi          = {{10.1016/j.atherosclerosis.2024.117576}},
  year         = {{2024}},
}