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<p>Exposure to fine particulate matter (PM<sub>2.5</sub>) and its constituents has been associated with disease-specific mortality, but the impact on ischemic heart disease (IHD) mortality remains unclear. This study aimed to evaluate the short-term effect of PM<sub>2.5</sub>, its constituents on the risk of IHD mortality. We employed a time-stratified case-crossover design to evaluate the short-term effect between PM<sub>2.5</sub>, its constituents and IHD deaths in Hunan Province, Central China, from January 2013 to December 2019. The PM<sub>2.5</sub> and its constituents, including black carbon (BC), organic matter (OM), sulfate (SO<sub>4</sub><sup>2−</sup>), ammonium (NH<sub>4</sub><sup>+</sup>), and nitrate (NO<sub>3</sub><sup>−</sup>), were estimated based on geocoded residential address. A distributed lag nonlinear model (DLNM) combined with conditional logistic regression model was employed to assess the associations of PM<sub>2.5</sub> and its constituents with IHD mortality. A total of 387,832 IHD deaths were recorded. The risk of IHD mortality increases with the elevation of PM<sub>2.5</sub> and its constituents. The strongest cumulative associations specific to the median concentrations of PM<sub>2.5</sub> and SO<sub>4</sub><sup>2−</sup> were observed at Lag07, with odds ratios (ORs) of 1.115 (95% CI: 1.070, 1.161) and 1.120 (95% CI: 1.082, 1.159), respectively. For acute myocardial infarction (AMI), the cumulative associations of PM<sub>2.5</sub> and BC were strongest at Lag02, with OR values of 1.122 (95% CI: 1.042, 1.208) and 1.136 (95% CI: 1.054, 1.224), respectively. Subgroup analyses revealed that stronger associations between PM<sub>2.5</sub> exposure and IHD mortality were observed in elderly populations and during cold-month periods. If the median concentration of PM<sub>2.5</sub> decreases to WHO-recommended Air Quality Guidelines (AQG) level, the attributable IHD-related mortality risk would be reduced to 6.80%, 3.51% and 3.57%, respectively. Short-term exposure to PM<sub>2.5</sub> and its constituents showed significant associations with IHD-related mortality. Our findings have implications for optimizing air quality management policies to alleviate the influence of PM<sub>2.5</sub> and its constituents on IHD mortality.</p>

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Ambient fine particulate matter, constituents, and ischemic heart disease mortality: a time-stratified case-crossover analysis in Central China

  • 期刊论文

  • 发表日期：

    2026年4月10日

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  • Ling-Shuang Lv,
  • Xiu-Ying Liu,
  • Yuan Liu,
  • Zi-Tong Zhuang,
  • Xin-Ye Zhang,
  • Yue-Hua Hu,
  • Ji Hu,
  • Te-Hui Zeng,
  • Li-Dong Gao,
  • Xin Xia,
  • Li Yin

摘要

Exposure to fine particulate matter (PM2.5) and its constituents has been associated with disease-specific mortality, but the impact on ischemic heart disease (IHD) mortality remains unclear. This study aimed to evaluate the short-term effect of PM2.5, its constituents on the risk of IHD mortality. We employed a time-stratified case-crossover design to evaluate the short-term effect between PM2.5, its constituents and IHD deaths in Hunan Province, Central China, from January 2013 to December 2019. The PM2.5 and its constituents, including black carbon (BC), organic matter (OM), sulfate (SO42−), ammonium (NH4+), and nitrate (NO3−), were estimated based on geocoded residential address. A distributed lag nonlinear model (DLNM) combined with conditional logistic regression model was employed to assess the associations of PM2.5 and its constituents with IHD mortality. A total of 387,832 IHD deaths were recorded. The risk of IHD mortality increases with the elevation of PM2.5 and its constituents. The strongest cumulative associations specific to the median concentrations of PM2.5 and SO42− were observed at Lag07, with odds ratios (ORs) of 1.115 (95% CI: 1.070, 1.161) and 1.120 (95% CI: 1.082, 1.159), respectively. For acute myocardial infarction (AMI), the cumulative associations of PM2.5 and BC were strongest at Lag02, with OR values of 1.122 (95% CI: 1.042, 1.208) and 1.136 (95% CI: 1.054, 1.224), respectively. Subgroup analyses revealed that stronger associations between PM2.5 exposure and IHD mortality were observed in elderly populations and during cold-month periods. If the median concentration of PM2.5 decreases to WHO-recommended Air Quality Guidelines (AQG) level, the attributable IHD-related mortality risk would be reduced to 6.80%, 3.51% and 3.57%, respectively. Short-term exposure to PM2.5 and its constituents showed significant associations with IHD-related mortality. Our findings have implications for optimizing air quality management policies to alleviate the influence of PM2.5 and its constituents on IHD mortality.