The Role of Environmental PM_2.5 in Admission Acute Heart Failure in ST-Elevation Myocardial Infarction patients - An Observational Retrospective Study

Figures & data

Table 1 Baseline Characteristics of STEMI Patients and Comparison Between STEMI Patients without and with Acute Admission Heart Failure

Clinical Admission Characteristics	All Patients (n = 290)	No Heart Failure (n = 189)	Heart Failure (n = 101)	p
Women (%)	34.5	25.9	50.5	< 0.001
Age ≥ 65 years	54.1	45	71.3	< 0.001
Smoking (%)	38.3	43.9	27.7	0.008
Arterial hypertension (%)	62.8	60.8	66.3	0.375
Prior MI (%)	12.8	11.1	15.8	0.271
Diabetes (%)	21.4	14.8	33.7	< 0.001
Pain to primary PCI < 6 h (%)	62	65	56.4	0.167
Pain to primary PCI < 3 h (%)	42	42.3	41.5	1.000
Anterior STEMI (%)	42.4	41.2	44.6	0.620
LBBB (%)	4.1	0.5	10.9	< 0.001
Prior resuscitation (%)	13.1	8.4	21.8	0.003
Troponin I ≥ 5 ug/L (%)	33.1	25.9	46.7	< 0.001
Mean serum creatinine ± SD (µmol/L)	98.5±51.2	82.7±24.9	129.4±71.7	< 0.001
Mean eGFR ± SD (mL/min/1.73m^2)	72.2±26.5	82±22.3	52.9±23.3	< 0.001

Abbreviations: MI, myocardial infarction; PCI, percutaneous coronary intervention; STEMI, ST-elevation myocardial infarction; LBBB, left bundle branch block; eGFR, estimated glomerular filtration rate.

Table 2 PM_2.5 Levels in All Included STEMI Patients and Comparison Between STEMI Patients without and with Acute Admission Heart Failure

PM2.5 Levels (ug/m^3)	All Patients (n = 290)	No Heart Failure (n = 189)	Heart Failure (n = 101)	p
Admission mean ± SD	16.12 ± 11.25	15.4 ± 10.5	17.5 ± 12.5	0.166
A day before admission mean ± SD	15.7 ± 10.89	14.8 ± 9.3	17.4 ± 13.3	0.059
Admission levels ≥ 20ug/m^3 (%)	25.9	23.3	30.7	0.205
Levels one day before admission ≥ 20 ug/m^3 (%)	23.4	19	31.7	0.020

Abbreviations: SD, standard deviation; PM, particulate matter.

Table 3 Independent Predictors of Admission Acute Admission Heart Failure in STEMI Patients

Admission Characteristics	OR	95% CI	p
Gender (women vs men)	1.500	0.750 to 3.010	0.252
Age ≥ 65 years (yes vs no)	1.550	0.740 to 3.250	0.244
Smoking (yes vs no)	1.10	0.530 to 2.280	0.805
eGFR (per 10 units)	0.610	0.520 to 0.720	< 0.001
Diabetes (yes vs no)	2.440	1.100 to 5.400	0.028
LBBB (yes vs no)	10.190	1.160 to 89.36	0.036
Prior resuscitation (yes vs no)	2.530	1.010 to 6.340	0.048
Admission Troponin I≥ 5 ug/L (yes vs no)	3.390	1.74 to 6.62	< 0.001
PM2.5 ≥ 20 ug /m^3 one day before admission (yes vs no)	2.140	1.005 to 4.560	0.049

Abbreviations: LBBB, left bundle branch block; eGFR, estimated glomerular filtration rate; PM, particulate matter.

Table 4 Hospital Treatment and Mortality in All Included STEMI Patients and Comparison Between STEMI Patients without and with Acute Admission Heart Failure

Hospital Data	All Patients (n = 290)	No Heart Failure (n =189)	Heart Failure (n = 101)	p
Primary PCI	92.1	94.7	87.1	0.038
TIMI III after PCI	76.2	82.	65.3	0.002
Peak Troponin I ≥ 50 ug/L	37.6	32.2	47.5	0.001
Mean EF ± SD (%)	45.9±13.9	48.8±12.4	39.83±15	< 0.001
EF < 55% (%)	61.6	54.9	76.1	0.004
Hospital heart failure (%)	34.5	13.7	73.3	<0.001
IABP (%)	2.5	0.5	6.0	0.009
Hospital mortality	12.8	2.6	31.7	< 0.001

Abbreviations: PCI, primary percutaneous coronary intervention; TIMI, thrombolysis in myocardial infarction; EF, ejection fraction; IABP, intra-aortic balloon pump.