The following article is part of conference coverage from the American College of Cardiology (ACC.20) /World Congress of Cardiology. The Cardiology Advisor‘s staff is reporting on research conducted by leading experts in cardiology. Check back for the latest news from the ACC.20.

Air pollution may represent a significant factor in the progression of atherosclerosis and increase carotid intima-media thickness (cIMT), particularly in individuals with coronary artery disease (CAD), according to study results intended to be presented at the annual meeting of the American College of Cardiology (ACC 2020).

Researchers conducted a cross-sectional study in which air pollution exposure was estimated using a time series of microparticle exposure and by measuring ozone concentration. Participants were classified as living in areas of high or low air pollution.  Ultrasonography was used to assess cIMT.

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In this cohort (n=149 with CAD; n=1033 without CAD), the mean cIMT was greater in participants with vs without CAD (1.37±0.74 vs 0.96±0.38, respectively; P <.001). After adjusting for confounders, preexisting CAD and air pollution levels were found to have an effect on mean cIMT in a propensity score analysis (F [1-216]=4.374; P =.038).

Participants with CAD in the high vs low air pollution group were found to have increased mean (1.53±0.79 vs 1.18±0.59, respectively; P =.002). The cIMT of individuals without CAD were comparable whether they resided in a high or low air pollution environment (1.45±0.5 vs 1.44±0.52, respectively; P =.883).

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“Air pollution may significantly contribute to atherosclerosis progression and increase cIMT, especially in subjects with CAD, highlighting the additive adverse impact of environmental factors on atherosclerotic cardiovascular disease,” concluded the study authors.


Oikonomou E, Mystakidi V-C, Theofillis P, et al. The impact of air pollution on atherosclerosis burden. Intended to be presented at: American College of Cardiology 69th Annual Scientific Session; March 28-30, 2020; Chicago, IL. Presentation 905-06.

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