Residential noise exposure is associated with the risk of early-onset myocardial infarctionResults from the DECIBEL-MI Study

Hatim Kerniss (Bremen)1, L. A. Mata Marín (Bremen)1, K. Clemens (Bremen)1, C. Litfin (Bremen)1, A. Seidel-Sarpong (Bremen)1, S. Rühle (Bremen)1, J. Schmucker (Bremen)1, R. Osteresch (Bremen)1, A. Fach (Bremen)1, R. Hambrecht (Bremen)1, H. Wienbergen (Bremen)1

1Bremer Institut für Herz- und Kreislaufforschung (BIHKF) Bremen, Deutschland


Results from the DECIBEL-MI (Determination of Environmental CIty-noise's Burden, Exposure, and Link to Myocardial Infarction) Study


Previous studies indicated that persistent noise exposure increases cardiovascular morbidity and mortality. However, data is scarce and noise is not yet included in risk scores for cardiovascular events. It was the purpose of the present study to investigate, whether noise exposure is associated with the risk of myocardial infarction (MI) at young age.
All consecutive patients aged ≤ 50 years with acute MI who were admitted to the heart center Bremen between 2015 and 2023 were included. The LIFE-CVD model was used to determine the 10-year cardiovascular risk of the patients based on traditional risk factors. The Geoportal Bremen was used to estimate both the daytime (Lden) and nighttime (Lnight) residential noise exposure levels.
The study population of 391 patients ≤ 50 years with MI had a significantly higher rate of residential noise exposure compared to the general population in Bremen, regarding both Lden (65% compared to 53%, p < 0.01) and Lnight (55% compared to 41%, p < 0.01). 
Patients with MI that were exposed to high noise levels (≥55dB) had a lower risk based on traditional risk factors (calculated by the Life-CVD score) compared to those exposed to low noise exposure (Lden 3.38% vs. 5.46%, p < 0.01; Lnight 2.90% vs. 4.35%, p < 0.01). Patients with MI and low LIFE-CVD score (≤2.5%) had a significantly higher categorized noise exposure than those with high LIFE-CVD score (2.28 vs. 1.38, p < 0.01 for Lden, and 1.74 vs. 1.01, p < 0.01 for Lnight). Figure 1 demonstrates in four LIFE-CVD score categories that average noise exposure increased with decreasing traditional risk factors. 
Linear regression analysis, adjusted for potential confounding factors, such as socioeconomic status, confirmed a significant inverse association between noise exposure and LIFE-CVD Score (p < 0.01).
Patients with early-onset MI who had a low rate of traditional risk factors were exposed to high levels of residential noise (even after adjustment by multivariate analysis). The data indicates that noise pollution should be considered as risk factor to develop MI at young age and prevention efforts to reduce noise pollution should be intensified. 

Figure 1: Comparison of Lden (noise exposure) in patients with MI ≤ 50 years with different 10-year LIFE-CVD risk categories (traditional risk factors)

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