Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021
Background: Ambient temperatures and PM2.5 can trigger myocardial infarction (MI), while little is known about the complex interplay between these two factors on MI, especially morbidity. Objectives: To investigate bidirectional effect modifications of temperature and PM2.5 on MI morbidity and morta...
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Elsevier
2025-01-01
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| Series: | Ecotoxicology and Environmental Safety |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651325000181 |
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| author | Piaopiao Hu Qinghui Zeng Jie Chang Moning Guo Feng Lu Yue Qi Zhao Yang Pingping Jia Qiuju Deng Jing Liu |
| author_facet | Piaopiao Hu Qinghui Zeng Jie Chang Moning Guo Feng Lu Yue Qi Zhao Yang Pingping Jia Qiuju Deng Jing Liu |
| author_sort | Piaopiao Hu |
| collection | DOAJ |
| description | Background: Ambient temperatures and PM2.5 can trigger myocardial infarction (MI), while little is known about the complex interplay between these two factors on MI, especially morbidity. Objectives: To investigate bidirectional effect modifications of temperature and PM2.5 on MI morbidity and mortality. Methods: A time-stratified case-crossover study was conducted utilizing high-resolution data of temperature and PM2.5, along with 498,077 MI cases from the citywide registry in Beijing, China from 2007 to 2021. A conditional logistic regression model combined with a distributed lag non-linear model was used to examine linear and categorical effect modifications of temperature and PM2.5 on MI morbidity and mortality. Results: The PM2.5 effect on MI morbidity, modified by temperature, showed a progressive increase of odds ratio from 1.013 (95 % CI: 1.001, 1.025) to 1.027 (95 % CI: 1.012, 1.042) with rising temperatures. Stratified analysis revealed a greater PM2.5 effect in high temperature strata (1.049, 95 % CI: 1.029, 1.069) compared with low strata (1.007, 95 % CI: 0.993, 1.021) on MI morbidity (PZ test<0.001). The temperature effect on MI morbidity was also modified by PM2.5, with a gradual upward risk trend observed with increasing PM2.5 concentration. Specifically, the heat wave effect was greater at high PM2.5 concentration strata (1.097, 95 % CI: 1.042, 1.155) than at low strata (0.954, 95 % CI: 0.890, 1.023) (PZ test=0.002). The cold spell effect was greater at high PM2.5 concentration strata (1.181, 95 % CI: 1.117, 1.249) than at low strata (0.883, 95 % CI: 0.740, 1.053) (PZ test=0.002). A similar bidirectional effect modification of temperature and PM2.5 was also found in MI mortality. Conclusions: Temperature and PM2.5 bidirectionally modify their effect on MI morbidity and mortality. Elevated temperatures exacerbate PM2.5 effect, while increased concentrations of PM2.5 amplify temperature effect. The combined effect of temperatures and PM2.5 should be stressed, encompassing not only extreme conditions but also the entire range of exposures. |
| format | Article |
| id | doaj-art-4a684f8d6b9a4e6695db58bb8147af7c |
| institution | Kabale University |
| issn | 0147-6513 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Elsevier |
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| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-4a684f8d6b9a4e6695db58bb8147af7c2025-01-23T05:26:05ZengElsevierEcotoxicology and Environmental Safety0147-65132025-01-01289117682Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021Piaopiao Hu0Qinghui Zeng1Jie Chang2Moning Guo3Feng Lu4Yue Qi5Zhao Yang6Pingping Jia7Qiuju Deng8Jing Liu9Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, ChinaCenter for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, ChinaCenter for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, ChinaBeijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, ChinaBeijing Municipal Health Big Data and Policy Research Center, Beijing, China; Beijing Institute of Hospital Management, Beijing, ChinaCenter for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, ChinaCenter for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, ChinaCenter for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, ChinaCenter for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; Correspondence to: Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases, No. 2 An Zhen Road, Chaoyang District, Beijing 100029, China.Center for Clinical and Epidemiologic Research, Beijing An Zhen Hospital, Capital Medical University, Beijing, China; Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China; National Clinical Research Center of Cardiovascular Diseases, Beijing, China; The Key Laboratory of Remodeling-Related Cardiovascular Diseases, Ministry of Education, Beijing, China; The Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China; Correspondence to: Beijing An Zhen Hospital, Capital Medical University; Beijing Institute of Heart, Lung, and Blood Vessel Diseases, No. 2 An Zhen Road, Chaoyang District, Beijing 100029, China.Background: Ambient temperatures and PM2.5 can trigger myocardial infarction (MI), while little is known about the complex interplay between these two factors on MI, especially morbidity. Objectives: To investigate bidirectional effect modifications of temperature and PM2.5 on MI morbidity and mortality. Methods: A time-stratified case-crossover study was conducted utilizing high-resolution data of temperature and PM2.5, along with 498,077 MI cases from the citywide registry in Beijing, China from 2007 to 2021. A conditional logistic regression model combined with a distributed lag non-linear model was used to examine linear and categorical effect modifications of temperature and PM2.5 on MI morbidity and mortality. Results: The PM2.5 effect on MI morbidity, modified by temperature, showed a progressive increase of odds ratio from 1.013 (95 % CI: 1.001, 1.025) to 1.027 (95 % CI: 1.012, 1.042) with rising temperatures. Stratified analysis revealed a greater PM2.5 effect in high temperature strata (1.049, 95 % CI: 1.029, 1.069) compared with low strata (1.007, 95 % CI: 0.993, 1.021) on MI morbidity (PZ test<0.001). The temperature effect on MI morbidity was also modified by PM2.5, with a gradual upward risk trend observed with increasing PM2.5 concentration. Specifically, the heat wave effect was greater at high PM2.5 concentration strata (1.097, 95 % CI: 1.042, 1.155) than at low strata (0.954, 95 % CI: 0.890, 1.023) (PZ test=0.002). The cold spell effect was greater at high PM2.5 concentration strata (1.181, 95 % CI: 1.117, 1.249) than at low strata (0.883, 95 % CI: 0.740, 1.053) (PZ test=0.002). A similar bidirectional effect modification of temperature and PM2.5 was also found in MI mortality. Conclusions: Temperature and PM2.5 bidirectionally modify their effect on MI morbidity and mortality. Elevated temperatures exacerbate PM2.5 effect, while increased concentrations of PM2.5 amplify temperature effect. The combined effect of temperatures and PM2.5 should be stressed, encompassing not only extreme conditions but also the entire range of exposures.http://www.sciencedirect.com/science/article/pii/S0147651325000181Effect modificationTemperaturePM2.5Myocardial infarction |
| spellingShingle | Piaopiao Hu Qinghui Zeng Jie Chang Moning Guo Feng Lu Yue Qi Zhao Yang Pingping Jia Qiuju Deng Jing Liu Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021 Ecotoxicology and Environmental Safety Effect modification Temperature PM2.5 Myocardial infarction |
| title | Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021 |
| title_full | Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021 |
| title_fullStr | Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021 |
| title_full_unstemmed | Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021 |
| title_short | Bidirectional effect modifications of temperature and PM2.5 on myocardial infarction morbidity and mortality in Beijing, China from 2007 to 2021 |
| title_sort | bidirectional effect modifications of temperature and pm2 5 on myocardial infarction morbidity and mortality in beijing china from 2007 to 2021 |
| topic | Effect modification Temperature PM2.5 Myocardial infarction |
| url | http://www.sciencedirect.com/science/article/pii/S0147651325000181 |
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