Coronary disease & ACS

Chronic PM2.5 Exposure Is Associated With Invasively Assessed Coronary Endothelial Dysfunction

J Am Coll CardiolPublished Prospective cohort study

Main finding · EED per 1 μg/m³ increase in PM2.5Result — go to the resultOdds ratio 1.078 95% CI 1.021–1.139

Authors' conclusion

Chronic PM2.5 exposure is associated with epicardial coronary ED, suggesting a potential biological link between PM2.5 and CAD.

Study context

Population
Patients with angina and nonobstructive coronary artery disease (CAD) undergoing coronary reactivity testing at Mayo Clinic, 2000–2023
Participants
1,485 patients
Exposure
Chronic PM2.5 exposure
Outcome
Epicardial endothelial dysfunction (EED; <−20% change in coronary diameter in response to acetylcholine)
Methodological detailssingle-centre, generalized propensity score with stabilized inverse probability weights
  • Single-centre
  • Generalized propensity score with stabilized inverse probability weights

Main finding

EED per 1 μg/m³ increase in PM2.5

Odds ratio

1.078

95% CI 1.021–1.139

P = 0.007

PM2.5 per 1 μg/m³ increase
OR 1.078 (95% CI 1.021–1.139); P = 0.007

Per 1 μg/m³ increase, as printed

As reported in the abstract

Observational data: associations, not effects.

Further findings

Characteristics of patients exposed to PM2.5 above EPA standards (9 μg/m³)

Younger, fewer CV comorbidities, worse lipid profiles

Original publication

Chronic PM2.5 Exposure Is Associated With Invasively Assessed Coronary Endothelial Dysfunction. J Am Coll Cardiol. Published 20 May 2026. doi:10.1016/j.jacc.2026.03.155

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