Association of Long-Term Exposure to PM _2.5 Components with Quality of Life in Patients with Acute Coronary Syndrome

This study aims to explore the association of long-term exposure to particulate matter with aerodynamic diameters ≤ 2.5 μm (PM 2.5 ) and its components with the quality of life in patients hospitalized with acute coronary syndrome (ACS). It also measures the potential modification effects of genetic susceptibility and medication history. A total of 5,137 patients hospitalized with ACS were included from north China, with 3-year average concentrations of PM 2.5 and its components assigned to the residential addresses. For each patient, EuroQol 5 dimensions questionnaire with 3 levels (EQ-5D-3L) was used to measure quality of life; polygenic risk score (PRS) was calculated to evaluate genetic susceptibility. The multivariate linear mixed model and ordinal logistic model were fitted to assess the influence of PM 2.5 components on EQ-5D-3L utility values by domains, and the modification effects of genetic susceptibility and medication history. Weighted quantile sum method was applied to detect the key PM 2.5 component. EQ-5D-3L utility values changed by −1.49% (95% CI: −2.46% to −0.53%) for each interquartile range (IQR) increase in the concentration of PM 2.5 , with sulfate owning the largest weight (0.63). Lower effect size of PM 2.5 was observed for patients using antiplatelet agents, statins, and β blockers, or those with low PRS than other patients, although certain intra-group difference was insignificant. Long-term exposure to PM 2.5 components was associated with lower quality of life in ACS patients, and the effect of sulfate and individuals with high PRS should be particularly aware. The use of certain medicine may reduce the adverse effect of PM 2.5 .