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Research Paper | Cardiology Science | United Kingdom | Volume 11 Issue 10, October 2022
Exogenous Formaldehyde in the Exacerbation of Coronary Artery Disease: An Observational Study with Meta - Analysis
India Premjithlal Bhaskaran | Arya Premjithlal Bhaskaran | Anusuya Premjithlal Bhaskaran | Premjithlal Bhaskaran
Abstract: Background: Exposure to formaldehyde induces coronary artery disease (CAD) such as atherosclerosis, arrhythmia, tachycardia, ventricular or atrial fibrillation, stroke and it is linked to oxidative stress or inflammation. Higher concentrations of formaldehyde exposure can cause negative inotropic strength in the heart, sinoatrial dysfunction, which can result in bradycardia or death. The aim of this study was to identify the risk for cardiac events due to formaldehyde toxicity and to assess the transition in formaldehyde concentration. Materials and methods: For systematic review and meta-analysis, PubMed, EMBASE, ProQuest and Cochrane database were searched, by using the terms ?formaldehyde and coronary artery disease?. Studies addressed association between exposure to formaldehyde and cardiac events or hospital admissions / visits or incidence of myocardial infarction was the inclusion criteria. Studies published (English literature) from ?January 2010 to August 2022? were included. The ?Mantel?Haenszel Risk Ratio? was used for meta-analysis. For the observational component, the formaldehyde levels were obtained from a school and its peripheral areas based in west London and Margate in United Kingdom. The formaldehyde concentration was measured at 8:00 and 17:00 hours during 2018 to 2022. Results: Overall, 104 titles or abstracts were identified from the initial search, of which full manuscripts of 97 studies were retrieved, in the first phase. Later, 91 studies were excluded and six were subjected to meta-analysis. The mean formaldehyde concentration (daily exposure) across the studies ranged between 0.37 mg/m3 to 5.4 mg/m3. The majority (90%) of studies reported estimates for hospitalization due to formaldehyde including myocardial infarction. The risk ratio was 1.16 (95% C.I = 1.04 to 1.29) and hence for every unit (?g/m3) increment in the formaldehyde concentration, contribute the risk for coronary artery disease (CAD). The observational component of this study reveals that, formaldehyde levels were unstable across the time points and it reduced in 2020. Conclusion: The risk for cardiac events due to formaldehyde toxicity was higher and the formaldehyde levels were dynamic. There was an association between formaldehyde exposure and CAD, including myocardial infarction and stroke. The formaldehyde concentration and longevity of exposure has a pivotal role in the exacerbation of CAD. Hence a critical evaluation of ECG / ECHO / cardiac markers should be performed among exposed cases to prevent further complications.
Keywords: Cardiac dysfunction, exposure, risk factor, Myocardial Infarction
Edition: Volume 11 Issue 10, October 2022,
Pages: 454 - 459