Association of air pollution exposure and genetic susceptibility with increased risk of thoracic aortic aneurysm and dissection.

Thoracic aortic aneurysm and dissection (TAAD) represent a serious health threat, yet the role of air pollution exposure on its development has been underexplored. Here we investigate the relationships between air pollutants and TAAD incidence. In a Cox's proportional hazards model, hazard ratios (95% confidence intervals) of TAAD for an interquartile range increase in air pollutants were 2.15 (1.96, 2.35) for particulate matter with an aerodynamic diameter ≤2.5 μm (PM_2.5; per 2.15 μg m^-3 increase), 1.76 (1.61, 1.92) for PM₁₀ (per 2.99 μg m^-3 increase), 1.45 (1.34, 1.58) for NO₂ (per 6.97 μg m^-3 increase) and 1.40 (1.29, 1.51) for NO_x (per 11.58 μg m^-3 increase). These estimates remained consistent when using inverse probability weighting and generalized propensity score methods. Furthermore, this study revealed potential joint effects and interactions between air pollutants and genetic susceptibility on TAAD risk, especially the multiplicative and additive interactions between PM_2.5 and genetic susceptibility. Air pollution exposure is associated with an increased TAAD risk and genetic susceptibility modifies this association.