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Long-term exposure of fine particulate matter air pollution and incident atrial fibrillation in the general population: A nationwide cohort study

 In-Soo Kim  ;  Pil-Sung Yang  ;  Jinae Lee  ;  Hee Tae Yu  ;  Tae-Hoon Kim  ;  Jae-Sun Uhm  ;  Hui-Nam Pak  ;  Moon-Hyoung Lee  ;  Boyoung Joung 
 International Journal of Cardiology, Vol.283 : 178-183, 2019 
Journal Title
 International Journal of Cardiology 
Issue Date
Air pollution ; Atrial fibrillation ; General population ; Incidence ; Particulate matter
BACKGROUND: Although many studies have linked elevations in fine particulate matter (PM2.5) air pollution to adverse cardiovascular outcomes, long-term exposures of PM2.5 on air pollution-related incident atrial fibrillation (AF) in general population have not yet been investigated well. METHODS: We included 432,587 subjects of general population not diagnosed with AF from the Korean National Health Insurance Service-National Sample Cohort from 2009 to 2013. Medical records were screened from January 2002 to investigate the subjects' disease-free baseline period. They were followed until December 2013. We matched subjects' residential ZIP code with hourly measurements of air pollutant (particulate and gaseous) concentrations and meteorological (temperature and humidity) data during the study period. RESULTS: During 1,666,528 person·years, incident AF was observed in 5825 subjects (350/100,000 person·year). We found significant associations between incident AF and long-term average concentrations of PM2.5 (HR = 1.179[1.176-1.183] for 10 μg/m3 increments, p < 0.001), PM10 (HR = 1.034[1.033-1.036] for 10 μg/m3 increments, p < 0.001), and gaseous air pollutants during the study period. When dividing subjects into subgroups, these long-term exposures of PM2.5 effects were more profound in males (HR = 1.187[1.183-1.192], p < 0.001), older subjects (aged ≥ 60 years; HR = 1.194[1.188-1.200], p < 0.001), those who were obesity (body mass index ≥ 27.5 kg/m2, HR = 1.191[1.183-1.199], p < 0.001), subjects with previous myocardial infarction (HR = 1.203[1.186-1.221], p < 0.001), and history of hypertension (HR = 1.191[1.185-1.197], p < 0.001) (each interaction p < 0.05 compared to the opposite subgroup). CONCLUSIONS: Even in the Asian general population, long-term exposure of PM2.5 is associated with the increased incidence of new-onset AF. It is more profound in obese male subjects > 60-year old and who have a history of hypertension or previous myocardial infarction.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, In-Soo(김인수) ORCID logo https://orcid.org/0000-0003-2801-5514
Kim, Tae-Hoon(김태훈) ORCID logo https://orcid.org/0000-0003-4200-3456
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Uhm, Jae Sun(엄재선) ORCID logo https://orcid.org/0000-0002-1611-8172
Yu, Hee Tae(유희태) ORCID logo https://orcid.org/0000-0002-6835-4759
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
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