Home > Riviste > Panminerva Medica > Fascicoli precedenti > Panminerva Medica 2020 December;62(4) > Panminerva Medica 2020 December;62(4):252-9

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

ORIGINAL ARTICLE   

Panminerva Medica 2020 December;62(4):252-9

DOI: 10.23736/S0031-0808.20.04161-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Impact of temporary traffic bans on the risk of acute coronary syndromes in a large metropolitan area

Francesco VERSACI 1, Achille GASPARDONE 2, Alessandro DANESI 3, Fabio FERRANTI 4, Massimo MANCONE 5, Enrica MARIANO 6, Francesco L. ROTOLO 7, Carmine MUSTO 8, Igino PROIETTI 9, Andrea BERNI 10, Carlo TRANI 11, Sonia C. SERGI 12, Giulio SPECIALE 13, Gaetano TANZILLI 5, Fabrizio TOMAI 14, Alessandro D. DI GIOSA 15, Giada MARCHEGIANI 15, Simone CALCAGNO 1, Enrico ROMAGNOLI 11, Giacomo FRATI 16, 17, Giuseppe BIONDI ZOCCAI 16, 18

1 UOC UTIC Emodinamica e Cardiologia, S. Maria Goretti Hospital, Latina, Italy; 2 Division of Cardiology, S. Eugenio Hospital, Rome, Italy; 3 Division of Cardiology, S. Spirito Hospital, Rome, Italy; 4 Division of Cardiology, G. B. Grassi Hospital, Rome, Italy; 5 Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, Umberto I Hospital, Sapienza University, Rome, Italy; 6 Department of Cardiology, Tor Vergata University, Rome, Italy; 7 Interventional Cardiology Unit, San Pietro Fatebenefratelli Hospital, Rome, Italy; 8 Interventional Cardiology Unit, San Camillo Hospital, Rome, Italy; 9 Division of Cardiology, M. G. Vannini Hospital, Rome, Italy; 10 Department of Cardiovascular Diseases, Sant’Andrea Hospital, Rome, Italy; 11 IRCCS A. Gemelli University Polyclinic Foundation, Rome, Italy; 12 Division of Cardiology, Casilino Hospital, Rome, Italy; 13 Division of Cardiology, S. Filippo Hospital, Rome, Italy; 14 Division of Cardiology, Aurelia Hospital, Rome, Italy; 15 Agenzia Regionale per la Protezione Ambientale (ARPA) Lazio, Rome, Italy; 16 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy; 17 IRCCS Istituto Neurologico Mediterraneo (NEUROMED), Pozzilli, Isernia, Italy; 18 Mediterranea Cardiocentro Clinic, Naples, Italy



BACKGROUND: Strong epidemiologic evidence has highlighted the role of pollution, on top of adverse climate features, as a novel cardiovascular risk factor. However, mechanistic proof that reducing pollution may be beneficial to prevent atherothrombotic events is limited. We aimed at appraising the impact of temporary traffic bans in a large metropolitan area on the risk of acute coronary syndromes.
METHODS: Aggregate and anonymized data from 15 tertiary cardiac care centers were obtained detailing precoronavirus disease 2019 (COVID-19) daily cases of ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI), including those treated with percutaneous coronary intervention (PCI). Data on pollutants and climate were sought for the same days. Mixed level regression was used to compare the week before vs after the traffic ban (Fortnight analysis), the 3 days before vs. after (Weekly analysis) and the Sunday before vs. after (Sunday analysis).
RESULTS: A total of 8 days of temporary traffic bans were included, occurring between 2017 and 2020, totaling 802 STEMI and 1196 NSTEMI in the Fortnight analysis, 382 STEMI and 585 in the Weekly analysis, and 148 STEMI and 210 NSTEMI in the Sunday analysis.Fortnight and Sunday analyses did not disclose a significant impact of traffic ban on STEMI or NSTEMI (all P>0.05). Conversely, Weekly analysis showed non-significant changes for STEMI, but a significant decrease in daily NSTEMI when comparing the 3 days before the traffic ban with the ban day (P=0.043), as well as the 3 days before vs. the 3 days after the ban (P=0.025). No statistically significant effect of traffic ban was found at Fortnight, Weekly or Sunday analyses for daily mean concentrations of benzene, carbon monoxide, nitric oxide, nitrogen dioxide, ozone, sulfur dioxide, particulate matter (PM) <2.5 µm or PM <10 µm (all P>0.05). However, minimum daily concentrations showed a significant reduction of ozone during the ban in comparison to the week preceding it (P=0.034), nitric oxide during the ban in comparison to the 3 days preceding it (P=0.046), and an increase in benzene during the ban in comparison to the Sunday before (P=0.039).
CONCLUSIONS: Temporary traffic ban may favorably reduce coronary atherothrombotic events, and in particular NSTEMI, even if not globally and immediately impacting on environmental pollution. Further controlled studies are required to confirm and expand this hypothesis-generating results.


KEY WORDS: Acute coronary syndrome; Cardiovascular diseases; Environment; Traffic-related pollution

inizio pagina