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Fine Particulate Matter Exposure and Risk of Major Adverse Cardiac and Cerebrovascular Events (MACCE) in

Chaiyawat Suppasilp1, Teeranan Angkananard2, Romen Samuel Rodis Wabina1

  • 1Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.

Global Heart
|March 23, 2026
PubMed
Abstract

Insights

Fine particulate matter (PM2.5) exposure significantly increases the risk of major adverse cardiac and cerebrovascular events (MACCE) in patients after percutaneous coronary intervention (PCI). Reducing PM2.5 is crucial for improving patient outcomes and lessening disease burden.

Area of Science:

  • Environmental Health
  • Cardiovascular Research
  • Public Health

Background:

  • Major adverse cardiac and cerebrovascular events (MACCE) are critical outcomes for patients undergoing percutaneous coronary intervention (PCI).
  • Limited evidence exists on the impact of fine particulate matter (PM2.5) on MACCE in this patient population.
  • Understanding environmental risk factors like PM2.5 is essential for improving cardiovascular care.

Purpose of the Study:

  • To investigate the association between fine particulate matter (PM2.5) exposure and the incidence of MACCE in Thai adults who underwent PCI.
  • To quantify the risk of MACCE associated with varying levels of PM2.5 exposure.
  • To inform public health strategies aimed at mitigating cardiovascular risks.

Main Methods:

  • Retrospective cohort study of 22,188 Thai adults undergoing PCI.
  • Cumulative PM2.5 exposure estimated using satellite data based on residential locations over a 12-month follow-up.
  • Multilevel survival model used to assess the association between PM2.5 and MACCE, adjusting for confounders.

Main Results:

  • A 1 µg/m³ increase in PM2.5 exposure was associated with a 45% increased risk of MACCE (aHR 1.45).
  • Higher seasonal PM2.5 exposure, particularly in Q3 (aHR 1.50), showed a significant association with MACCE.
  • 28.8% of patients experienced at least one MACCE during the median 11.97-month follow-up.

Conclusions:

  • Higher seasonal PM2.5 exposure is significantly associated with an increased risk of MACCE in patients post-PCI.
  • Findings highlight the urgent need for public health policies to reduce PM2.5 levels.
  • Reducing PM2.5 exposure can improve cardiovascular health outcomes and decrease the disease burden.
Keywords:
PM2.5cardiovascular eventscoronary artery diseasefine particulate matterpercutaneous coronary intervention

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