PM2.5 concentration in the ambient air is a risk factor for the development of high-risk coronary plaques

Seokhun Yang, Seung Pyo Lee, Jun Bean Park, Heesun Lee, Si Hyuck Kang, Sang Eun Lee, Juyong Brian Kim, Su Yeon Choi, Yong Jin Kim, Hyuk Jae Chang

Research output: Contribution to journalArticlepeer-review

48 Citations (Scopus)


Aims: We aimed to investigate whether long-term exposure to particulate matter with an aerodynamic diameter <2.5 μm (PM2.5) in the ambient air is related to the development or growth of coronary plaques. Methods and results: This study involved 364 residents of Seoul, Korea, who underwent serial coronary computed tomographic angiography (CCTA) at an interval of ≥2 years. Each participant's average concentration of residential PM2.5 between the two CCTAs was calculated. Primary endpoint was the development of high-risk plaque (HRP), defined as a plaque with low attenuation, spotty calcium, and positive remodelling. Secondary endpoints were the volume increase of total plaque and its component volume. Among those without HRP at baseline (n = 341), 20 patients developed HRP at follow-up CCTA, the residential PM2.5 concentration of which was significantly higher than those without HRP at follow-up (25.8 ± 2.0 vs. 25.0 ± 1.7 μg/m3 for patients with newly developed HRP vs. patients without HRP at follow-up; P = 0.047). An increase in PM2.5 concentration was associated with increased incidence of HRP at follow-up [adjusted hazard ratio (aHR) 1.62, 95% confidence interval (CI) 1.22-2.15, P < 0.001]. In a secondary analysis, the PM2.5 concentration was associated with an increased risk of the formation of either fibrofatty or necrotic core component in newly developed plaques (aHR 1.41, 95% CI 1.23-1.61, P < 0.001), and with a higher risk of total plaque volume progression in the pre-existing plaques (aHR 1.14, 95% CI 1.05-1.23, P = 0.002). Conclusion: Exposure to higher concentration of PM2.5 in the ambient air is significantly associated with the development of high-risk coronary plaques.

Original languageEnglish
Pages (from-to)1355-1364
Number of pages10
JournalEuropean heart journal cardiovascular Imaging
Issue number12
Publication statusPublished - 2019 Dec 1

Bibliographical note

Funding Information:
This work was supported by grants from the Korean Health Technology R&D Project (HI15C0399), Ministry of Health, Welfare & Family Affairs, South Korea to S.-P.L.

Publisher Copyright:
© 2019 Published on behalf of the European Society of Cardiology. All rights reserved.

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'PM2.5 concentration in the ambient air is a risk factor for the development of high-risk coronary plaques'. Together they form a unique fingerprint.

Cite this