TY - JOUR T1 - Associations between short-term exposure to PM<sub>2.5</sub> and cardiomyocyte injury in myocardial infarction survivors in North Carolina JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2021-001891 VL - 9 IS - 1 SP - e001891 AU - Lauren Wyatt AU - Gauri Kamat AU - Joshua Moyer AU - Anne M Weaver AU - David Diaz-Sanchez AU - Robert B Devlin AU - Qian Di AU - Joel D Schwartz AU - Wayne E Cascio AU - Cavin K Ward-Caviness Y1 - 2022/06/01 UR - http://openheart.bmj.com/content/9/1/e001891.abstract N2 - Objective Short-term ambient fine particulate matter (PM2.5) is associated with adverse cardiovascular events including myocardial infarction (MI). However, few studies have examined associations between PM2.5 and subclinical cardiomyocyte damage outside of overt cardiovascular events. Here we evaluate the impact of daily PM2.5 on cardiac troponin I, a cardiomyocyte specific biomarker of cellular damage.Methods We conducted a retrospective cohort study of 2924 patients identified using electronic health records from the University of North Carolina Healthcare System who had a recorded MI between 2004 and 2016. Troponin I measurements were available from 2014 to 2016, and were required to be at least 1 week away from a clinically diagnosed MI. Daily ambient PM2.5 concentrations were estimated at 1 km resolution and assigned to patient residence. Associations between log-transformed troponin I and daily PM2.5 were evaluated using distributed lag linear mixed effects models adjusted for patient demographics, socioeconomic status and meteorology.Results A 10 µg/m3 elevation in PM2.5 3 days before troponin I measurement was associated with 0.06 ng/mL higher troponin I (95% CI=0.004 to 0.12). In stratified models, this association was strongest in patients that were men, white and living in less urban areas. Similar associations were observed when using 2-day rolling averages and were consistently strongest when using the average exposure over the 5 days prior to troponin I measurement.Conclusions Daily elevations in PM2.5 were associated with damage to cardiomyocytes, outside of the occurrence of an MI. Poor air quality may cause persistent damage to the cardiovascular system leading to increased risk of cardiovascular disease and adverse cardiovascular events.Data are available upon reasonable request. Data access to electronic health records from the University of North Carolina Healthcare System is through an internal data use agreement. PM2.5 data was obtained through collaboration with Drs Joel Schwartz (Harvard TH Chan School of Public Health) and Qian Di (Tsinghua University). For general data sharing inquiries, contact ward-caviness.cavin@epa.gov. ER -