Please use this identifier to cite or link to this item:
DC FieldValue
dc.titleTime-Stratified Case Crossover Study of the Association of Outdoor Ambient Air Pollution With the Risk of Acute Myocardial Infarction in the Context of Seasonal Exposure to the Southeast Asian Haze Problem
dc.contributor.authorHo, A.F.W.
dc.contributor.authorZheng, H.
dc.contributor.authorEarnest, A.
dc.contributor.authorCheong, K.H.
dc.contributor.authorPek, P.P.
dc.contributor.authorSeok, J.Y.
dc.contributor.authorLiu, N.
dc.contributor.authorKwan, Y.H.
dc.contributor.authorTan, J.W.C.
dc.contributor.authorWong, T.H.
dc.contributor.authorHausenloy, D.J.
dc.contributor.authorFoo, L.L.
dc.contributor.authorTan, B.Y.Q.
dc.contributor.authorOng, M.E.H.
dc.identifier.citationHo, A.F.W., Zheng, H., Earnest, A., Cheong, K.H., Pek, P.P., Seok, J.Y., Liu, N., Kwan, Y.H., Tan, J.W.C., Wong, T.H., Hausenloy, D.J., Foo, L.L., Tan, B.Y.Q., Ong, M.E.H. (2019). Time-Stratified Case Crossover Study of the Association of Outdoor Ambient Air Pollution With the Risk of Acute Myocardial Infarction in the Context of Seasonal Exposure to the Southeast Asian Haze Problem. Journal of the American Heart Association 8 (6) : e011272. ScholarBank@NUS Repository.
dc.description.abstractBackground: Prior studies have demonstrated the association of air pollution with cardiovascular deaths. Singapore experiences seasonal transboundary haze. We investigated the association between air pollution and acute myocardial infarction (AMI) incidence in Singapore. Methods and Results: We performed a time-stratified case-crossover study on all AMI cases in the Singapore Myocardial Infarction Registry (2010–2015). Exposure on days where AMI occurred (case days) were compared with the exposure on days where AMI did not occur (control days). Control days were chosen on the same day of the week earlier and later in the same month and year. We fitted conditional Poisson regression models to daily AMI incidence to include confounders such as ambient temperature, rainfall, wind-speed, and Pollutant Standards Index. We assessed relationships between AMI incidence and Pollutant Standards Index in the entire cohort and subgroups of individual-level characteristics. There were 53 948 cases. Each 30-unit increase in Pollutant Standards Index was association with AMI incidence (incidence risk ratio [IRR] 1.04, 95% CI 1.03–1.06). In the subgroup of ST-segment–elevation myocardial infarction the IRR was 1.00, 95% CI 0.98 to 1.03, while for non–ST-segment–elevation myocardial infarction, the IRR was 1.08, 95% CI 1.05 to 1.10. Subgroup analyses showed generally significant. Moderate/unhealthy Pollutant Standards Index showed association with AMI occurrence with IRR 1.08, 95% CI 1.05 to 1.11 and IRR 1.09, 95% CI 1.01 to 1.18, respectively. Excess risk remained elevated through the day of exposure and for >2 years after. Conclusions: We found an effect of short-term air pollution on AMI incidence, especially non–ST-segment–elevation myocardial infarction and inpatient AMI. These findings have public health implications for primary prevention and emergency health services during haze. © 2019 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
dc.publisherAmerican Heart Association Inc.
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 International
dc.sourceScopus OA2019
dc.subjectair pollution
dc.subjectmyocardial infarction
dc.contributor.departmentDEAN'S OFFICE (DUKE-NUS MEDICAL SCHOOL)
dc.contributor.departmentSAW SWEE HOCK SCHOOL OF PUBLIC HEALTH
dc.contributor.departmentDUKE-NUS MEDICAL SCHOOL
dc.description.sourcetitleJournal of the American Heart Association
Appears in Collections:Staff Publications

Show simple item record
Files in This Item:
File Description SizeFormatAccess SettingsVersion 
10_1161_JAHA_118_011272.pdf275.96 kBAdobe PDF




checked on Jan 25, 2023

Page view(s)

checked on Jan 26, 2023

Google ScholarTM



This item is licensed under a Creative Commons License Creative Commons