Health Condition 1: I219- Acute myocardial infarction, unspecified
Conditions
Interventions
Intervention1: Different and Changing levels of Pollutants act as Quasi-interventions: We are conducting a Prospective, Quasi-Experimental Observational Study where we observe ACS patients and associa
Sponsors
Subharti Medical College
PearResearch
Eligibility
Inclusion criteria
Inclusion criteria: Adults 18 years or more with ACS confirmed per Fourth Universal Definition of ACS
Exclusion criteria
Exclusion criteria: Type 2 MI (per ESC 2023 guidelines) Takotsubo cardiomyopathy Chronic inflammatory or autoimmune diseases
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| To quantify the association between short term ambient pollutant exposure 1, 7 and 15 days prior to admission, long term exposure more than 12 months prior to the index event and ACS incidence in a high pollution, urban Indian cohortTimepoint: To quantify the association between short term ambient pollutant exposure 1, 7 and 15 days prior to admission, long term exposure more than 12 months prior to the index event and ACS incidence in a high pollution, urban Indian cohort | — |
Secondary
| Measure | Time frame |
|---|---|
| To stratify ACS severity (Killip class, STEMI vs NSTEMI prevalence) across Air Quality Index categoriesTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To model dose-response relationships between PM exposure lag 0 2 days & exposure to other pollutants & inflammatory biomarkers hs-CRP, IL-6 using Generalized Additive ModelsTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To assess whether PM exposure thresholds (25th vs. 75th percentile) predict in-hospital mortality & Left Ventricular Ejection Fraction reductionTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To evaluate the association of co-morbdities & confounders like smoking, diabetes, hypertension & dyslipidemia on effect of air pollution on ACSTimepoint: Baseline;To assess TIMI thrombus grade variation with prior 3-day PM averagesTimepoint: 3 days;To analyze short-term (30-day) MACE rates across AQI quartilesTimepoint: 30 days;To compare IL-6 & hs-CRP levels & other biomarkers in ACS patients admitted during severe pollution vs. good air quality daysTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To evaluate the association between NO exposure & arrhythmia occurrence during hospitalizationTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To determine pollutant-specific risk contribution to ACS subtypesTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To explore geospatial exposure gradients using inverse distance weighted pollution estimates & their association with ACS outcomesTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To explore role of seasonal & temporal variations & their association with ACS incidence & outcomesTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year;To validate the feasibility of integrating environmental exposure data into ACS risk stratification models in Indian tertiary centers The Mehta-Sethi ScoreTimepoint: Baseline, 1 week, 15 days, 30 days, 1 year | — |
Countries
India
Contacts
Public ContactYashendra Sethi
Subharti Medical College
Outcome results
None listed