Aims: Short-term effects of Polish smog, particularly benzo(alpha)pyrene [B(a)P], are unclear. We aimed to examine the association between short-term exposure to air pollution and ischaemic stroke (IS) incidence. Methods and results: We conducted a retrospective population-based cohort study including an EP-PARTICLES cohort of 8 million inhabitants in the years 2011–20 (80 million person-years of observation). Individual clinical data on emergency hospitalizations due to IS (ICD-10: I63.X) was analysed. We used quasi-Poisson models to examine municipality-specific associations between air pollutants and IS, considering various covariates. We recorded 146 262 cases of IS with a dominance of females (51.8%) and people over 65 years old (77.6%). In the overall population, exposure to PM2.5, NO2, B(a)P, and SO2 increased the risk of IS onset on the day of exposure by 2.4, 1, 0.8, and 0.6%, respectively. Age and sex were modifying variables for PM2.5, NO2, and B(a)P exposure with more pronounced effects in non-elderly individuals and women (all Pinteraction < 0.001). Residents of regions with high tobacco and alcohol consumption were more sensitive to the effects of PM2.5 and SO2. The slopes of response–effect curves were non-linear and steeper at lower concentrations. Conclusion: Exposure to air pollution may be associated with higher IS incidence, particularly posing a higher risk to non-elderly women. Harmful lifestyle habits might exacerbate its impact. Exposure to even low levels of air pollutants had negative effects. Registration: The study was registered at ClinicalTrials.gov (NCT05198492).

Air pollution (AP) is linked up to 20% of cardiovascular deaths. The aim of this nationwide study was to investigate subpopulations vulnerable to AP for non-ST- (NSTEMI) and ST-elevation myocardial infarction (STEMI) incidence. We analysed short- (lags up to seven days) and mid-term (0–30 days moving average) influence of particulate matter (PM_2.5), sulphur dioxide (SO₂), nitrogen dioxide (NO₂) and benzo(a)pyrene (BaP) on hospitalizations due NSTEMI and STEMI in 2011–2020. Data on AP concentrations were derived using GEM-AQ model. Study included residents of five voivodeships in eastern Poland, inhabited by over 8,000,000 individuals. Higher NO₂ and PM_2.5 concentrations increased mid-term risk of NSTEMI in patients aged < 65 years by 1.3–5.7%. Increased SO₂ and PM_2.5 concentration triggered STEMI in the short- (SO₂, PM_2.5) and mid-term (PM_2.5) amongst those aged ≥ 65 years. In the short- and mid-term, women were more susceptible to PM_2.5 and BaP influence resulting in increased STEMI incidence. In rural regions, STEMI risk was triggered by SO₂, PM_2.5 and BaP. Income-based stratification showed disproportions regarding influence of BaP concentrations on NSTEMI incidence based on gross domestic product (up to 1.4%). There are significant disparities in the influence of air pollution depending on the demographic and socio-economic factors. AP exposure is associated with the threat of a higher risks of NSTEMI and STEMI, especially to younger people, women, residents of rural areas and those with lower income. National Science Center and Medical University of Bialystok, Poland.

In the aging society, the issue of coronary chronic total occlusion (CTO) has become a challenge for invasive cardiologists. Despite the lack of clear indications in European and American guidelines, the rates of percutaneous coronary interventions (PCI) for CTO increased over the last years. Well-conducted randomized clinical trials (RCT) and large observational studies brought significant and substantial progress in many CTO blind spots. However, the results regarding the rationale behind revascularization and the long-term benefit of CTO are inconclusive. Knowing the uncertainties regarding PCI CTO, our work sought to sum up and provide a comprehensive review of the latest evidence on percutaneous recanalization of coronary artery chronic total occlusion.

Aims: Air pollution remains the single largest environmental health risk factor, while atrial fibrillation (AF) is the most prevalent arrhythmia globally. The study aimed to investigate the relationship between short-term exposure to air pollution and acute AF admissions. Methods and results: Individual data on AF hospitalization in the years 2011–20 were collected from the National Health Fund in Poland (ICD-10: I48.XX). To obtain high-resolution data on air pollution, we applied a modelling method using the GEM-AQ model. Associations between air pollution exposure and acute AF admissions were estimated using generalized additive models with Poisson regression. Over the analysed period, we recorded 252 566 acute admissions due to AF. Each 10 µg/m3 increment of particulate matter with diameters ≤2.5 (PM2.5) and nitrogen dioxide (NO2) concentration, 1 µg/m3 of sulfur dioxide and 10 ng/m3 of benzo(a)pyrene (BaP) concentration on the day of exposure resulted in 1.13% (0.70−1.55%), 1.65% (1.05−2.26%), 0.11% (0.01−0.21%), and 0.3% (0.04−0.55%) increases in acute AF admissions, respectively. The estimates are larger for women and older people. Stronger associations between PM2.5 and BaP concentrations and AF admissions in poorly urbanized areas were noted. Areas with high gross domestic product levels were more affected by the increase in NO2 concentrations, resulting in a 0.2% (1.001–1.003) increase in AF admissions. Exposure-response functions show steeper slopes of the pollutant-outcome associations in the lower ranges of exposures, far below World Health Organization (WHO) air quality guideline norms. For the zero-emission scenario, we estimate avoidable AF admissions—5873 for PM2.5 (95% confidence interval 3679 to 8047) and 3295 for NO2 (2108–4477). Conclusion: Air pollution acts as a triggering factor and can be associated with acute AF hospitalizations. PM2.5 and NO2 have an impact on AF even at concentrations levels below WHO air quality guideline norms.

Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO₂) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016–2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m³ increase in air pollutants was associated with an increase in mortality due to ACS (PM_2.5 OR = 1.029, 95%CI 1.011–1.047, p = 0.002; PM₁₀ OR = 1.015, 95%CI 1–1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM_2.5 OR = 1.03, 95%CI 1.001–1.058, p = 0.04) and ACS (PM_2.5 OR = 1.028, 95%CI 1.01–1.047, p = 0.003; PM₁₀ OR = 1.026, 95%CI 1.011–1.041, p = 0.001; NO₂ OR = 1.036, 95%CI 1.003–1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM_2.5 OR = 1.032, 95%CI 1.006–1.058, p = 0.01; PM₁₀ OR = 1.028, 95%CI 1.008–1.05, p = 0.01) and elderly (ACS: PM_2.5 OR = 1.03, 95%CI 1.01–1.05, p = 0.003; PM₁₀ OR = 1.027, 95% CI 1.011–1.043, p < 0.001 and IS: PM_2.5 OR = 1.037, 95%CI 1.007–1.069, p = 0.01; PM₁₀ OR = 1.025, 95%CI 1.001–1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO₂ was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.

Introduction: Cardiovascular diseases, particularly myocardial infarction (MI), significantly impact patients’ lives, causing stress and prompting varied responses to illness. Aim and methods: We conducted a narrative review concerning the acceptance of illness and quality of life in post-MI patients. Based on an extensive search of the available literature, this review consolidates current evidence on the proposed topic. Conclusions and implications: While some patients struggle with acceptance and face emotional distress, others who accept their condition are more likely to engage in treatment and lifestyle changes, leading to an improved health-related quality of life (HRQoL). Following an MI, patients often experience depression, anxiety, and stress, complicating their acceptance of the illness. Risk factors, such as hypertension, diabetes, and smoking, play a significant role in influencing HRQoL in post-MI patients. An accurate assessment of HRQoL is crucial for tailoring effective treatments and support strategies to enhance patient outcomes and identify those most at risk of developing post-MI depression or anxiety. Effective physician–patient and nurse–patient communication and support from family might be helpful in recovery. Cardiac rehabilitation improves patients’ outcomes and HRQoL. This review underscores the importance of integrating psychological support with optimal medical care to improve patient prognosis and enhance the HRQoL of individuals recovering from MI. The healthcare system could implement routine psychological assessments for MI patients at admission and discharge to establish a baseline for follow-up. Future research should explore effective psychological interventions, the interplay of CVD risk factors and psychosocial aspects, the emerging role of artificial intelligence in personalized care, and the cost-effectiveness of integrated treatment models.