Long-term fine particulate matter exposure and coronary artery disease: unravelling cardiometabolic pathways and modification of genetic susceptibility
Year: 2025
Type: article
Abstract: AIMS: Which cardiometabolic risk factors (CMRFs) primarily mediate the association between long-term fine particulate matter (PM2.5) exposure and coronary artery disease (CAD) incidence, and whether participants with high genetic risks of CMRFs are more susceptible remain unclear. METHODS AND RESULTS: This study was based on the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China. Long-term PM2.5 concentration was assessed by satellite-based spatiotemporal model at 1 km resolution. Mediation analyses were conducted to assess the mediating contribution of CMRFs for PM2.5 and CAD, and then stratified by genetic risk of CMRFs. Additive interaction was additionally evaluated on modification of genetic risk for PM2.5 and CAD. During a median follow-up of 11.15 years, 941 CAD cases of 34 481 participants were recorded. Each 10 μg/m3 increase in PM2.5 exposure was associated with a 28% increased risk of CAD [hazard ratio: 1.28; 95% confidence interval (CI): 1.19-1.37]. Systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C) emerged as the primary mediators, with mediating proportions of 13.02% (95% CI: 4.63-21.42) and 9.23% (95% CI: 0.34-18.12), respectively. Notably, individuals with high genetic risk exhibited greater mediating proportions at 18.99% (95% CI: 6.43-31.55) and 16.30% (95% CI: 5.11-27.52) then those with low genetic risk at 2.42% (95% CI: -16.80 to 21.64) and 6.15% (95% CI: -8.13 to 20.43). Meanwhile, the genetic risks of SBP and LDL-C also significantly exacerbated CAD risk related to PM2.5 exposure, demonstrating additive interaction (P < 0.05). CONCLUSION: This study provided a combination of conventional and genetic evidence to underscore the importance of integrated management targeting blood pressure and blood cholesterol to mitigate CAD burden when PM2.5 exposure is unavoidable.
Institutions: Chinese Academy of Medical Sciences & Peking Union Medical College, Fu Wai Hospital, Southern University of Science and Technology, Tianjin Medical University, Nanjing Medical University, Shenzhen University, Zhengzhou University, Shenzhen University Health Science Center, Emory University
Language: English
Subfield: Health, Toxicology and Mutagenesis
Field: Environmental Science
Domain: Physical Sciences
Open Access status: bronze
OpenAlex ID: W4409758183