Coronary disease & ACSResearch article
Influences of socioeconomic and environmental factors on ST-elevation myocardial infarction (STEMI) incidence and related mortality: insights from the Belgian Environmental Myocardial Infarction Risk (EMIR) Study
- time-stratified case-crossover design
- 9 years of national hospital discharge data
- Multivariable logistic regression
Authors' conclusion
Environmental factors through air pollution are associated with STEMI incidence, whereas socioeconomic factors such as financial precarity are related to in-hospital mortality. New risk models integrating socioeconomic and environmental vulnerabilities are needed to ensure early recognition and reinforced care for patients at risk of adverse outcomes.
Study context
- Population
- All STEMI admissions in Belgium (2012–14, 2016–21)STEMI admissions (51.3 per 100,000 inhabitants/year)
- Participants
- 51,544 admissions
- Comparison
- Associations between short-term air pollution exposures and STEMI admission; clinical, socioeconomic, and environmental determinants of in-hospital mortality
Main finding
As reported in the abstract
Same-day STEMI admission per interquartile range increase in PM2.5 · same-day
Odds ratio
1.022
95% CI 1.008–1.035
Interquartile range increase in PM2.5
OR 1.022 (95% CI 1.008–1.035)
Per interquartile range increase in PM2.5, as printed
Further findings
| Outcome | OR (95% CI) | |
|---|---|---|
| Same-day STEMI admission per interquartile range increase in NO2 · higher same-day STEMI admission risk | 1.044 (1.025–1.063) | |
| 0.512Odds ratio (log scale) |
STEMI admission with O3 over delayed exposure windows · lag 0-2
| Comparison | OR (95% CI) | |
|---|---|---|
| O3 · strongest at lag 0-2 | 1.063 (1.034–1.090) | |
| 0.512Odds ratio (log scale) |
In-hospital mortality
- In-hospital mortality
- 11.8%
- Most strongly associated with socioeconomic factors, including lower individual and area-level income and retirement status, alongside clinical characteristics
Original publication
Influences of socioeconomic and environmental factors on STEMI incidence and related mortality: insights from the Belgian Environmental Myocardial Infarction Risk (EMIR) Study. Eur Heart J Acute Cardiovasc Care. Published 2 September 2026. doi:10.1093/ehjacc/zuag118
Summarised from the published abstract; every number is checked against it