Impact of climate and air pollution on acute coronary syndromes: an update from the European Society of Cardiology Congress 2017.

NO ABSTRACT. THIS IS THE FIRST FEW PARAGRAPHS During the recent European Society of Cardiology (ESC) Congress 2017 several papers reported data on air pollution and ambient temperature in relation to myocardial infarction (MI). Environmental stressors have an unquestionable influence on cardiac health. In fact, global climate change may lead to a variety of negative effects on health, including increased risk of cardiovascular diseases. If greenhouse gas emissions continue unabated, the Intergovernmental Panel on Climate Change (IPCC) concludes with a high degree of certainty that, in most places, there will be more hot and fewer cold temperature extremes [1 Collins M, Knutti R, Arblaster J, For the IPCC: long-term climate change: projections, commitments and irreversibility. In: Stocker TF, Qin D, Plattner G-K, et al., editors. Climate Change Report 2013. Cambridge (UK): Cambridge University Press; 2013. Available from: http://www.climatechange2013.org/ [Google Scholar] ]. Accordingly, it is expected that within a few decades the increase in heat related mortality will outweigh gains due to fewer cold periods [2 Forzieri G, Cescatti A, Batista e Silva F, et al. Increasing risk over time of weather-related hazards to the European population: a data-driven prognostic study. Lancet Planet Health. 2017;1:e200–e208. [Crossref], [Google Scholar] ], especially in tropical developing countries with limited adaptive capacities and large exposed populations [3 Smith KR, Woodward A, Campbell-Lendrum D, et al. Human health: impacts, adaptation, and co-benefits. In: Field CB, Barros VR, Dokken DJ, et al., editors. Climate Change 2014: impacts, Adaptation, and Vulnerability. Part a: global and Sectoral Aspects. Contribution of Working Group II to the Fifth Assessment Report of the Intergovernmental Panel on Climate Change. Cambridge (UK): Cambridge University Press; 2014. p. 709–754. [Google Scholar] ]. Exposure to ambient air pollution increases morbidity and mortality, and is a leading contributor to the global disease burden [4 Cohen AJ, Brauer M, Burnett R, et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2015;389:1907–1918. [Crossref], [Web of Science ®], [Google Scholar] ]. In a recent study, global population-weighted mean concentrations of particle mass with aerodynamic diameter less than 2.5 μm (PM2.5) and ozone were estimated at an approximate 11 km × 11 km resolution using satellite-based estimates, chemical transport models, and ground-level measurements. According to this study, ambient PM2.5 was the fifth-ranking mortality risk factor in 2015. Exposure to PM2.5 caused 4.2 million deaths and 103.1 million disability-adjusted life-years (DALYs) in 2015, representing 7-6% of total global deaths and 4-2% of global DALYs, 59% of these in east and south Asia. In addition, the burning of solid cooking and heating fuels, which causes enhanced PM2.5 exposure indoors and in neighborhoods where these fuels are commonly used (denoted household air pollution), caused 2.8 million deaths and 85.6 million DALYs [4 Cohen AJ, Brauer M, Burnett R, et al. Estimates and 25-year trends of the global burden of disease attributable to ambient air pollution: an analysis of data from the Global Burden of Diseases Study 2015. Lancet. 2015;389:1907–1918. [Crossref], [Web of Science ®], [Google Scholar] ].