Influence of Air Quality on the Development and Progression of Premature Coronary Artery Disease
NCT Number: NCT06464042
Acronym: AIRHEART
Status: RECRUITING
Study Type: OBSERVATIONAL
Conditions: Coronary Artery Disease Premature|Angina, Stable|Acute Coronary Syndrome|MINOCA|Myocardial Infarction
Sponsor: pablo Juan-Salvadores
Collaborators: Fundacin Biomedica Galicia Sur|Conselleria de Saúde Pública de Galicia|Conselleria de Medio Ambiente, Territorio e Vivenda de Galicia
Sex: ALL
Age: ADULT
Enrollment: 4272
Study Design: Observational Model: |Time Perspective: p
Start Date: 2024-05-23
Completion Date: 2025-07-01
Locations: Hospital Álvaro Cunqueiro, Vigo, Pontevedra, 36211, Spain

Summary:
The new global guidelines from the World Health Organization on air quality provide evidence of the damage that air pollution inflicts on human health at even lower concentrations than previously thought. Different studies have shown an increase in the incidence of coronary artery disease (CAD) in young people in recent decades. The main objective of this project is to study the impact of environmental pollutants on the premature manifestation of CAD from different epidemiological approaches and their impact on the evolution of these patients with a gender perspective. It is a retrospective analytical case-control study nested in a cohort of patients ≤40 years old with a clinical history of CAD including: ST-segment elevation myocardial infarction, non-ST-segment elevation acute coronary syndrome, unstable angina, stable angina or silent angina according to the international classification of diseases.

Primary Outcome Measures: To determine the differences in exposure to environmental pollutants in patients ≤40 years old with and without coronary artery disease, The study will measure the levels of environmental pollutants (such as PM2.5, PM10, nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3), among others) in patients ≤40 years old with a clinical diagnosis of coronary artery disease and in patients without a diagnosis of coronary artery disease, in order to compare the differences., 15 years|To evaluate the impact of environmental pollutants on the incidence of the combined variable of major adverse cardiovascular events (MACE) up to 1, 5, and 10 years from the index cas, To evaluate the impact of environmental pollutants on the incidence of the combined variable of major adverse cardiovascular events (MACE) up to 1, 5, and 10 years from the index cas, 15 years|To describe the prevalence of CAD in patients ≤40 years old in Galicia, To describe the prevalence of CAD in patients ≤40 years old in Galicia, 15 years
Secondary Outcome Measures: To evaluate the influence of PM2.5 and PM10 particles on the early manifestation of CAD., The study will measure the levels of PM2.5, PM10 in patients ≤40 years old with a clinical diagnosis of coronary artery disease and in patients without a diagnosis of coronary artery disease, in order to compare the differences., 15 years|To describe the prevalence of ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), benzene (C6H6), carbon monoxide (CO), and heavy metals such as arsenic, cadmium, nickel, and lead in the premature manifestation of CAD., To describe the prevalence of ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2), benzene (C6H6), carbon monoxide (CO), and heavy metals such as arsenic, cadmium, nickel, and lead in the premature manifestation of CAD., 15 years|To determine the correlation of noise pollution with premature CAD by age and sex., To determine the correlation of noise pollution with premature CAD by age and sex., 15 years|To identify the impact of temperatures on early CAD by age and sex., The study will determine the impact of extreme temperatures, both heat and cold, on the premature presentation of coronary artery disease, by comparing this exposure between patients with and without the disease and sex., 15 years|To determine the correlation of environmental pollutants in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA)., To determine the correlation of environmental pollutants in patients with myocardial infarction with non-obstructive coronary arteries (MINOCA)., 15 years|To compare the effect of environmental pollutants and their relationship with CAD between men and women., The influence of different environmental pollutants on the premature presentation of coronary artery disease will be analyzed, taking into account the differences between women and men., 15 years|To evaluate the incidence of serious adverse events, To evaluate the incidence of recurrent myocardial infarction, revascularizations (unplanned after admission), stroke, death, major bleeding (BARC scale 2 or higher), hospital admission for stable angina, unstable angina, acute coronary syndrome with or without ST elevation, congestive heart failure (CHF), or heart transplant during 1, 5, and 10 years. By age and sex., 15 years