AIMS We aimed to investigate whether long-term exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) in the ambient air is related to the development or growth of coronary plaques. METHODS AND RESULTS This study involved 364 residents of Seoul, Korea, who underwent serial coronary computed tomographic angiography (CCTA) at an interval of ≥2 years. Each participant's average concentration of residential PM2.5 between the two CCTAs was calculated. Primary endpoint was the development of high-risk plaque (HRP), defined as a plaque with low attenuation, spotty calcium, and positive remodelling. Secondary endpoints were the volume increase of total plaque and its component volume. Among those without HRP at baseline (n = 341), 20 patients developed HRP at follow-up CCTA, the residential PM2.5 concentration of which was significantly higher than those without HRP at follow-up (25.8 ± 2.0 vs. 25.0 ± 1.7 μg/m3 for patients with newly developed HRP vs. patients without HRP at follow-up; P = 0.047). An increase in PM2.5 concentration was associated with increased incidence of HRP at follow-up [adjusted hazard ratio (aHR) 1.62, 95% confidence interval (CI) 1.22-2.15, P < 0.001]. In a secondary analysis, the PM2.5 concentration was associated with an increased risk of the formation of either fibrofatty or necrotic core component in newly developed plaques (aHR 1.41, 95% CI 1.23-1.61, P < 0.001), and with a higher risk of total plaque volume progression in the pre-existing plaques (aHR 1.14, 95% CI 1.05-1.23, P = 0.002). CONCLUSION Exposure to higher concentration of PM2.5 in the ambient air is significantly associated with the development of high-risk coronary plaques.

中文翻译：

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环境空气中的 PM2.5 浓度是高危冠状动脉斑块发展的危险因素。

目的 我们旨在调查长期暴露于环境空气中空气动力学直径 <2.5 μm (PM2.5) 的颗粒物是否与冠状动脉斑块的发展或生长有关。方法和结果 本研究涉及韩国首尔的 364 名居民，他们接受了间隔≥2 年的连续冠状动脉计算机断层扫描血管造影 (CCTA)。计算了每个参与者在两个 CCTA 之间的住宅 PM2.5 平均浓度。主要终点是高风险斑块 (HRP) 的发展，定义为具有低衰减、斑点钙和正重塑的斑块。次要终点是总斑块的体积增加及其成分体积。在基线时没有 HRP 的患者（n = 341）中，20 名患者在随访 CCTA（住宅 PM2.5）时出现 HRP。其中 5 浓度显着高于随访时没有 HRP 的患者（新出现 HRP 的患者与随访时没有 HRP 的患者的 25.8 ± 2.0 vs. 25.0 ± 1.7 μg/m3；P = 0.047）。PM2.5 浓度的增加与随访时 HRP 的发病率增加相关 [调整后的风险比 (aHR) 1.62, 95% 置信区间 (CI) 1.22-2.15, P < 0.001]。在二次分析中，PM2.5 浓度与新形成的斑块中形成纤维脂肪或坏死核心成分的风险增加相关（aHR 1.41, 95% CI 1.23-1.61, P < 0.001），并且与更高的预先存在的斑块中总斑块体积进展的风险（aHR 1.14, 95% CI 1.05-1.23, P = 0.002）。结论 暴露于较高浓度的 PM2.5 中。