Abstract

CASTRO, Pablo et al. Small particle air pollution (PM2.5) leads to an in crease in hospitalization rate for congestive heart failure. Rev Chil Cardiol [online]. 2010, vol.29, n.3, pp.306-314. ISSN 0718-8560.  http://dx.doi.org/10.4067/S0718-85602010000300004.

Background: Recent studies have reported an increase risk of hospitalization in patients with congestive heart failure (CHF) in association with air pollution by small particles. The Metropolitan región in Chile is characterized by high pollution indexes which are related to increased mortality from respiratory diseases. No systematic evaluation of the effect of particle pollution upon morbidity in patients with CHF is available.                                      Aim. To evaluate the association between fine particle pollution and hospitalization rate for decompensated CHF in hospitals participating in the ICARO registry of CHF in the Metropolitan área of Santiago. Methods. In a prospective design the clinical records of 529 patients who were hospitalized for decompensated CHF from Jan 2002 to Dec 2008 were analyzed Meteorological and pollution indexes were obtained from de MACAM monitoring network. A time stratified case cross-over design was used to study the association between hospitalization rate and pollution indexes (PM10 and PM25. Data was controlled for temperature and "punto de rocío" . A 0 to 10 day lateney period was es-timated to evalúate the influence of pollution on hospitalization rate. Results. The mean age of patients was 73.8 years. Etiologies for CHF included ischemic heart disease (27%) and hypertensive heart disease (27%). 73.2% of patients were hypertensives and 32.6% had evidence of DM. Hospitalization rate for CHF in men or women > 74 years of age increased from 22.7% 4 days after exposure to 44.8% 10 days after exposure (p=0.006). Diabetic patients were more susceptible to hospitalization with an 18% increased rate for each 10ug/m3 PM2.5 concentration at 8 days after exposure. Male and female hypertensive patients <74 years of age were also susceptible with a 28% (2.1 to 43/5%, CI) increase in hospitalization rate at 5 days after exposure. Conclusión: Patients with CHF who are diabetics or hypertensives are at increased risk of hospitalization for HF decompensation in relation to exposure to air pollution by PM2.5. Sex and age influence the risk. Mechanisms underlying these effeets are not yet elucidated.

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