Genetic risk modifies the effect of long-term fine particulate matter exposure on coronary artery disease

Jinyue Li; Fengchao Liang; Fangchao Liu; Jianxin Li; Keyong Huang; Xueli Yang; Shufeng Chen; Jie Cao; Chong Shen; Liancheng Zhao; Ying Li; Dongsheng Hu; Wending Wang; Jianbin Wu; Jianfeng Huang; Xiangfeng Lu; Dongfeng Gu

doi:10.1016/j.envint.2022.107624

Genetic risk modifies the effect of long-term fine particulate matter exposure on coronary artery disease

Environ Int. 2022 Dec:170:107624. doi: 10.1016/j.envint.2022.107624. Epub 2022 Nov 10.

Authors

Jinyue Li¹, Fengchao Liang², Fangchao Liu¹, Jianxin Li¹, Keyong Huang¹, Xueli Yang³, Shufeng Chen¹, Jie Cao¹, Chong Shen⁴, Liancheng Zhao¹, Ying Li¹, Dongsheng Hu⁵, Wending Wang⁶, Jianbin Wu⁷, Jianfeng Huang¹, Xiangfeng Lu⁸, Dongfeng Gu⁹

Affiliations

¹ Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China.
² School of Public Health and Emergency Management, Southern University of Science and Technology, Shenzhen 518055, China.
³ Tianjin Key Laboratory of Environment, Nutrition and Public Health, Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin 300203, China.
⁴ Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
⁵ Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou 450001, China; Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, Shenzhen 518071, China.
⁶ State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China; College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing 100049, China.
⁷ State Key Laboratory of Atmospheric Boundary Layer Physics and Atmospheric Chemistry, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China.
⁸ Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China. Electronic address: luxf@pumc.edu.cn.
⁹ Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, China; National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing 100037, China; School of Medicine, Southern University of Science and Technology, Shenzhen 518055, China. Electronic address: gudongfeng@cashq.ac.cn.

PMID: 36402033
DOI: 10.1016/j.envint.2022.107624

Abstract

Background: Although both environmental and genetic factors were linked to coronary artery disease (CAD), the extent to which the association of air pollution exposure with CAD can be influenced by genetic risk was not well understood.

Methods: A total of 41,149 participants recruited from the project of Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) were included. Genetic risk scores of CAD were constructed based on 540 genetic variants. Long-term PM_2.5 exposures were assessed by adopting satellite-based PM_2.5 estimations at 1-km resolution. We used stratified Cox proportional hazards regression model to examine the impact of PM_2.5 exposure and genetic risk on CAD risk, and further analyzed modification effect of genetic predisposition on association between PM_2.5 exposure and CAD risk.

Results: During a median of 13.01 years of follow-up, 1,373 incident CAD events were observed. Long-term PM_2.5 exposure significantly increased CAD risk, and the hazard ratios (HRs) [95% confidence intervals (CIs)] were 1.27 (1.05-1.54) and 1.95 (1.57-2.42) among intermediate and high PM_2.5 exposure groups compared to low PM_2.5 exposure group. The relative risks of CAD were 40% (HR: 1.40, 95%CI: 1.18-1.66) and 133% (HR: 2.33, 95%CI: 1.94-2.79) higher among individuals at intermediate and high genetic risk than those at low genetic risk. Compared with individuals with both low genetic risk and low PM_2.5 exposure, those with high genetic risk and high PM_2.5 exposure had highest CAD risk, with HR of 4.37 (95%CI: 3.13-6.11). We observed significant multiplicative (P < 0.001) and additive interaction [relative excess risk due to interaction (95%CI): 2.75 (1.32-4.20); attributable proportion due to interaction (95%CI): 0.56 (0.42-0.70)] between genetic risk and PM_2.5 exposure on CAD.

Conclusion: This study provided evidence that long-term PM_2.5 exposure might increase CAD risk, especially among people at high genetic risk. Our findings highlighted the importance of taking strategies on air quality improvement to cardiovascular disease prevention.

Keywords: Air pollution; Coronary artery disease; Fine particulate matter; Genetic risk; Interaction.

MeSH terms

Cardiovascular Diseases*
China / epidemiology
Coronary Artery Disease* / epidemiology
Coronary Artery Disease* / genetics
Humans
Particulate Matter / adverse effects
Risk Factors

Substances

Particulate Matter