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EAPC Quiz: Pollution and atherothrombotic risk

By Giuseppe Biondi-Zoccai, Population Science and Public Health Section

Risk Factors and Prevention

The case

A 58-year-old man with several cardiovascular risk factors (including hypertension, dyslipidemia and diabetes mellitus) is considering taking holidays with his spouse, and would like to pick a location. He is concerned that going on holidays in a heavily polluted place could put him at risk of adverse clinical events, and asks for your advice.

Test your knowledge

 

Note: The views and opinions expressed on this page are those of the author and may not be accepted by others. While every attempt is made to keep the information up to date, there is always going to be a lag in updating information. The reader is encouraged to read this in conjunction with appropriate ESC Guidelines. The material on this page is for educational purposes and is not for use as a definitive management strategy in the care of patients. Quiz material on the site are only examples and do not guarantee outcomes from formal examinations.

References

1. GBD 2019 Risk Factors Collaborators. Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020 Oct 17;396(10258):1223-1249. doi: 10.1016/S0140-6736(20)30752-2. PMID: 33069327; PMCID: PMC7566194.


2. Biondi-Zoccai G, Frati G, Gaspardone A, Mariano E, Di Giosa AD, Bolignano A, Dei Giudici A, Calcagno S, Scappaticci M, Sciarretta S, Valenti V, Casati R, Visconti G, Penco M, Giannico MB, Peruzzi M, Cavarretta E, Budassi S, Cosma J, Federici M, Roever L, Romeo F, Versaci F. Impact of environmental pollution and weather changes on the incidence of ST-elevation myocardial infarction. Eur J Prev Cardiol. 2021 Oct 25;28(13):1501-1507. doi: 10.1177/2047487320928450. PMID: 34695216.


3. Montone RA, Camilli M, Russo M, Termite C, La Vecchia G, Iannaccone G, Rinaldi R, Gurgoglione F, Del Buono MG, Sanna T, Trani C, Liuzzo G, Crea F, Niccoli G. Air Pollution and Coronary Plaque Vulnerability and Instability: An Optical Coherence Tomography Study. JACC Cardiovasc Imaging. 2021 Oct 7:S1936-878X(21)00692-6. doi: 10.1016/j.jcmg.2021.09.008. Epub ahead of print. PMID: 34656488.


4. Shimonovich M, Pearce A, Thomson H, Keyes K, Katikireddi SV. Assessing causality in epidemiology: revisiting Bradford Hill to incorporate developments in causal thinking. Eur J Epidemiol. 2021 Sep;36(9):873-887. doi: 10.1007/s10654-020-00703-7. Epub 2020 Dec 16. PMID: 33324996; PMCID: PMC8206235.