Cover Story Update
G
iven the migration crisis that has been driving
worldwide headlines for much of the summer,
our start-of-summer CSWN cover on “Future
CV Shock,” reporting the effects of war on medicine,
certainly was timely. Also prescient was the part of the
story dealing with the impact of climate change and
pollution on health. At this year’s ESC meeting, the
spotlight as on “The Environment and the Heart.” (And
no, we really had not noticed what the ESC was doing
when we were considering the June cover.) Here’s
what you need to know now.
In one featured presentation, Jean-Francois
Argacha, MD, head of the interventional clinic at University Hospital Brussels, reported that small increases in particulate matter (PM) and nitrogen dioxide
(NO2) air pollution are associated with increased risk
of severe myocardial infarctions, even when the increase is still within European recommended levels.
Between 2009 and 2013, there were 11,428 hospitalizations for ST-elevation myocardial infarction
(STEMI) and an increase of just 10 μg/m3 in ambient
PM concentrations (2.5 micrometers in diameter)
were associated with a 2.8% increase in STEMI
while 10 μg/m3 rises in NO2 were associated with
a 5.1% increased risk, although these associations
were only observed in men.
of C-reactive protein, high-sensitivity CRP, homocysteine, and fibrinogen levels in Krakow residents
compared to Lublin residents (p < 0.0001 for all). The
highest levels of these inflammatory markers was
found in overweight (body mass index 25-37 kg/m2)
participants living in Krakow.
“Our study shows that young adults living in a
polluted city have higher levels of inflammatory markers than those living in a city with less pollution,” said
Krzysztof Bryniarski, MD. “This may suggest that
these young adults are at greater risk of having a
heart attack in the future as the inflammatory process
has already started.”
Finally, two papers looked at the effect of cold
weather on STEMI and on stroke. According to research presented by Shuangbo Liu, MD, a resident at
the University of Manitoba, Winnipeg, an analysis of 6
years’ worth of data showed that each 10° Centigrade
drop in temperature (a drop of 18° Fahrenheit) was associated with a 7% increased risk