Air pollution and myocardial infarction in Rome - A case-crossover analysis
Air pollution and myocardial infarction in Rome - A case-crossover analysis
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DOI：
10.1097/01.ede.0000082046.22919.72
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发表时间：
2003-09-01
期刊：
影响因子：
5.4
通讯作者：
Perucci, CA
中科院分区：
文献类型：
--
作者：
D'Ippoliti, D;Forastiere, F;Perucci, CA
背景资料：每日空气污染与心血管疾病住院率的增加有关，但与急性心肌梗死的联系很少。评价城市空气中各种污染物之间的关系在意大利的罗马，我们进行了一项病例交叉分析，并研究了个体特征是否作为效应修饰因子。我们研究了居住在罗马的6531名首次急性心肌梗死住院患者（国际疾病分类，第9版：410），1995年1月至1997年6月。可获得以下个体信息：性别、年龄、住院日期、共存疾病（高血压，25%;糖尿病，15%）和心脏严重程度（传导障碍，6%;心律失常，20%;心力衰竭，11%）。每日空气污染数据来自5个城市监测器。我们采用了时间分层的情况下，交叉设计;控制天是同一天的一周心肌梗死发生，在其他周的month.Results：正相关被发现为总悬浮颗粒，NO2和CO。最强和最一致的效果被发现为总悬浮颗粒。在0- 2天的滞后期内，与总悬浮颗粒物10 μ g/m3相关的比值比（OR）为1.028（95%置信区间[CI] = 1.005-1.052）。与总悬浮颗粒物的关联在74岁以上的人群中往往更强（OR = 1.046，CI = 1.005-1.089），在温暖季节（OR = 1.046，CI = 1.008-1.087），在心脏传导障碍组中，结论：空气污染可增加心肌梗死的危险性，尤其是在温暖季节。老年人和心脏传导障碍的人有更强的影响的趋势。
Background: Daily air pollution is associated with increased hospital admissions for cardiovascular diseases, but there are few observations on the link with acute myocardial infarction. To evaluate the relation between various urban air pollutants (total suspended particulate, SO,, CO, NO,) and hospital admissions for acute myocardial infarction in Rome, Italy, we performed a case-crossover analysis and studied whether individual characteristics act as effect modifiers.Methods: We studied 6531 subjects residing in Rome and hospitalized for a first episode of acute myocardial infarction (International Classification of Diseases, 9th edition: 410) from January 1995 to June 1997. The following individual information was available: sex, age, date of hospitalization, coexisting illnesses (hypertension, 25%; diabetes, 15%), and cardiac severity (conduction disorders, 6%; cardiac dysrhythmias, 20%; heart failure, 11%). Daily air pollution data were taken from 5 city monitors. We used a time-stratified case-crossover design; control days were the same day of the week as the myocardial infarction occurred, in other weeks of the month.Results: Positive associations were found for total suspended particulate, NO2 and CO. The strongest and most consistent effect was found for total suspended particulate. The odds ratio (OR) associated with 10 mug/m(3) of total suspended particulate over the 0- to 2-day lag was 1.028 (95% confidence interval [CI] = 1.005-1.052). The association with total suspended particulate tended to be stronger among people older than 74 years of age (OR = 1.046; CI = 1.005-1.089), in the warm period of the year (OR = 1.046; CI = 1.008-1.087), and among subjects who had heart conduction disorders (OR = 1.080; Cl = 0.987-1.181).Conclusions: The results suggest that air pollution increases the risk of myocardial infarction, especially during the warm season. There was a tendency for a stronger effect among the elderly and people with heart conduction disturbances.