Po-03-151 ten-year effects of ambient pm2.5 exposure significantly increase sudden cardiac death, cardiovascular and all-cause mortalities: a nationwide cohort study.

Cardiovascular mortality and morbidity have been associated with the air pollution, but the chronic effects and its relation between pollutants and sudden cardiac death remain unclear. The study aimed to investigate the associations between sudden cardiac death, mortality, MACE and air pollutant in a 10-year follow-up nationwide cohort. This study used the National Health Insurance Research Database and comprised 16,778,374 participants over 20 years old staying in the same districts during 10-year follow-ups between 2008 to 2017 in Taiwan. Incidences of sudden cardiac death, all-cause and cardiovascular mortalities, heart failure, myocardial infarction and MACE were compared among air pollutant exposures (PM2.5, PM10, O3, NOx, NO, NO2, CO and SO2) to different quintiles. Mean 10-year exposures of all pollutants at different districts were obtained from Taiwan Environmental Protection Administration Database. The incidences of sudden cardiac death, all-cause and cardiovascular mortalities, myocardial infarction, stroke and MACE increased after mean PM2.5 exposure >23.8μg/m3 and were highest at the upper quantile (>33.0μg/m3) of PM 2.5 exposure, when compared to the other quantiles (p<0.001). All those incidences remained the same when mean PM2.5 exposure was below 23.7μg/m3(lowest & 2nd quantiles). These findings were not found in PM10, O3, NOx, NO, NO2, CO and SO2 pollutants among different quantiles, respectively. Details are show in Fig. A to H. Very long-term (10-year) exposure to ambient PM2.5 significantly increased the risk of sudden cardiac death cardiac and all-cause mortality. A positive correlated increase of those morbidities and mortalities happened after a mean PM2.5 cut-off value of 23.7μg/m3 .