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Long-Term Urban Air Pollution Tied to More Advanced Coronary Disease, Large CT Study Finds

The preliminary RSNA analysis emphasizes association, not causation.

Overview

  • Researchers analyzed more than 11,000 adults scanned from 2012 to 2023 at three Toronto hospitals, linking residential postal codes to 10-year average exposure and measuring coronary calcium, total plaque, and obstructive stenosis on cardiac CT.
  • Each 1 microgram per cubic meter increase in long-term PM2.5 corresponded to an 11% rise in coronary calcium, 13% greater odds of more plaque, and 23% greater odds of obstructive disease.
  • Nitrogen dioxide exposure showed parallel links to coronary disease with smaller effect sizes per 1 part per billion increase.
  • Sex-specific patterns emerged, with women showing higher calcium scores and more severe artery narrowing, whereas men showed higher calcium scores with greater plaque burden.
  • Associations were observed even at pollution levels near or below regulatory standards, and the authors urge further research to clarify mechanisms and causality as findings were presented at a medical meeting.