Evidence map›Paper›PMID 23849322›Full record

SynthesisLancet (London, England)2013

Global association of air pollution and heart failure: a systematic review and meta-analysis.

Anoop S V Shah, Jeremy P Langrish, Harish Nair, David A McAllister, Amanda L Hunter, Ken Donaldson, David E Newby, Nicholas L Mills

Registry-linked trialOpen access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Lancet (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02238028 (Short-term Cardiovascular Benefits of Wearing Particulate-filtering Respirators), which is not on this map. Cited by 410 papers, 27 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
410citing papers in PubMed, 27 pooled it
48.9field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02238028 nacompletednot on this mapstarted 2014, after this paper: background citation

Short-term Cardiovascular Benefits of Wearing Particulate-filtering Respirators: a Randomized Controlled Crossover Trial Among Healthy Young Adults

TypeinterventionalSponsorFudan UniversityRan2014 to 2014Enrolled28ConditionsAutonomic Nervous System Imbalance, Blood Pressure, Inflammation, VasoconstrictionArmsWear respirator
3 · Its place in the literature

Who cites it

410 citing papers in PubMed, 27 syntheses or guidelines pooled it, 1,210 citations in OpenAlex.

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  5. Chemical constituents of PMEuropean journal of pediatrics · 2025
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  11. Effects of air pollution on restricted activity days: systematic review and meta-analysis.Environmental health : a global access science source · 2023
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350 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 2 institutions in 2 countries.

Anoop S V ShahBHF/University Centre for Cardiovascular Science, University of Edinburgh, UK.
Jeremy P Langrish
Harish Nair
David A McAllister
Amanda L Hunter
Ken Donaldson
David E Newby
Nicholas L Mills
University of Edinburgh · GBPublic Health Foundation of India · IN

Funding

British Heart Foundation CH/09/002British Heart Foundation FS/10/024/28266British Heart Foundation PG/11/27/28842British Heart Foundation RG/10/9/28286British Heart Foundation SS/CH/09/002Medical Research Council G0901697
6 · The paper itself

Abstract

backgroundAcute exposure to air pollution has been linked to myocardial infarction, but its effect on heart failure is uncertain. We did a systematic review and meta-analysis to assess the association between air pollution and acute decompensated heart failure including hospitalisation and heart failure mortality.

methodsFive databases were searched for studies investigating the association between daily increases in gaseous (carbon monoxide, sulphur dioxide, nitrogen dioxide, ozone) and particulate (diameter <2·5 μm [PM2·5] or <10 μm [PM10]) air pollutants, and heart failure hospitalisations or heart failure mortality. We used a random-effects model to derive overall risk estimates per pollutant.

findingsOf 1146 identified articles, 195 were reviewed in-depth with 35 satisfying inclusion criteria. Heart failure hospitalisation or death was associated with increases in carbon monoxide (3·52% per 1 part per million; 95% CI 2·52-4·54), sulphur dioxide (2·36% per 10 parts per billion; 1·35-3·38), and nitrogen dioxide (1·70% per 10 parts per billion; 1·25-2·16), but not ozone (0·46% per 10 parts per billion; -0·10 to 1·02) concentrations. Increases in particulate matter concentration were associated with heart failure hospitalisation or death (PM2·5 2·12% per 10 μg/m(3), 95% CI 1·42-2·82; PM10 1·63% per 10 μg/m(3), 95% CI 1·20-2·07). Strongest associations were seen on the day of exposure, with more persistent effects for PM2·5. In the USA, we estimate that a mean reduction in PM2·5 of 3·9 μg/m(3) would prevent 7978 heart failure hospitalisations and save a third of a billion US dollars a year.

interpretationAir pollution has a close temporal association with heart failure hospitalisation and heart failure mortality. Although more studies from developing nations are required, air pollution is a pervasive public health issue with major cardiovascular and health economic consequences, and it should remain a key target for global health policy.

fundingBritish Heart Foundation.

Indexed as

Air PollutantsAir PollutionCarbon MonoxideEpidemiologic MethodsGlobal HealthHeart FailureHumansNitrogen DioxideOzoneParticulate MatterSulfur DioxideAir PollutantsCarbon MonoxideNitrogen DioxideOzoneParticulate MatterSulfur Dioxide

Identifiers

PMID23849322
PMCPMC3809511
OpenAlexW2132568490

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.