Fine Particulate Matter Exposure and Risk of Major Adverse Cardiac and Cerebrovascular Events (MACCE) in Post-Percutaneous Coronary Intervention (PCI) Patients: A Thai PCI Registry-Based Cohort Study.

A 1 µg/m3 increase in PM2.5 exposure was significantly associated with increased risk of MACCE in post-PCI patients.

• The adjusted hazard ratio for a 1 µg/m3 increase in PM2.5 was 1.45 (95% CI: 1.37, 1.54).
• This association was derived from a multilevel survival model adjusting for potential confounding variables.
• The study included 22,188 Thai adults who underwent PCI.
• During the median follow-up of 11.97 months (ranging from 0.03 to 12 months), 6,382 patients (28.8%) experienced at least one MACCE.

PM2.5 exposure showed quarterly seasonal variation in its association with MACCE risk in post-PCI patients.

• The adjusted HR for Q4 was 1.015 (95% CI: 1.005, 1.024).
• The adjusted HR for Q1 (peak PM2.5 season, around February) was 1.222 (95% CI: 1.132, 1.319).
• The adjusted HR for Q2 was 1.177 (95% CI: 1.096, 1.265).
• The adjusted HR for Q3 (lowest PM2.5 season) was 1.500 (95% CI: 1.381, 1.629).
• All quarterly hazard ratios were statistically significant based on their confidence intervals not crossing 1.0.

PM2.5 levels in Thailand exhibit a distinct seasonal pattern, peaking around February (Quarter 1) and reaching their lowest levels in Q3.

• Cumulative PM2.5 exposure was estimated using satellite-derived data based on patients' residential locations.
• The seasonal pattern was observed over the 12-month follow-up period.
• Despite lower absolute PM2.5 concentrations in Q3, the hazard ratio for MACCE was highest in Q3 (HR 1.500), suggesting a potentially complex relationship between seasonal exposure patterns and cardiovascular risk.

This retrospective cohort study used a Thai PCI Registry to examine the association between PM2.5 and MACCE over a 12-month follow-up period.

• The study included 22,188 Thai adults who underwent percutaneous coronary intervention.
• Baseline demographic, clinical characteristics, comorbidities, angiographic, and procedural data were collected.
• The primary outcome was a composite MACCE endpoint.
• A multilevel survival model was employed to assess the association between PM2.5 exposure and MACCE.
• Median follow-up was 11.97 months, ranging from 0.03 to 12 months.

The incidence of MACCE during follow-up was high among post-PCI patients in this Thai cohort.

• 6,382 patients (28.8%) experienced at least one MACCE during the follow-up period.
• The study population consisted of 22,188 Thai adults.
• The median follow-up was 11.97 months.