Traffic-related air pollution in relation to incidence and prognosis of coronary heart disease
Traffic-related air pollution in relation to incidence and prognosis of coronary heart disease
复制标题
DOI：
10.1097/ede.0b013e31815c1921
复制
发表时间：
2008-01-01
期刊：
影响因子：
5.4
通讯作者：
Perucci, Carlo A.
中科院分区：
文献类型：
--
作者：
Rosenlund, Mats;Picciotto, Sally;Perucci, Carlo A.
背景资料：长期空气污染暴露与死亡率增加有关，但与致命性和非致命性冠心病发病率的关系尚不确定。此外，尚不清楚长期暴露于空气污染如何影响首次冠状动脉事件幸存者的预后。本研究评估了长期交通相关的空气污染暴露和非致命性和致命性冠状动脉事件的发生率之间的关联，以及随后的再入院率和心肌梗死survivor.Methods死亡率：研究人群包括所有居民的罗马年龄在35-84岁，在1998-2000年期间。1995-1996年，采用土地利用回归模型（R-2 = 0.69）评估了住宅二氧化氮（NO2）暴露作为交通污染的标志。共观察到11，167例冠状动脉事件（4654例致死性，包括3598例院外冠状动脉死亡和6513例非致死性）。对6513名幸存者进行了4.0-7.5年的再入院或死亡随访，从首次事件发生之日起28天开始。通过Poisson回归（基于人群的发病率）和考克斯回归（队列分析）计算每10 μ g/m3 NO2暴露的相对风险，并调整年龄、性别和社会经济地位。结果：每10 μ g/m3 NO2暴露的冠状动脉事件发生率的相对风险为1.03（95%置信区间= 1.00-1.07）。致死性病例（1.07; 1.02-1.12）和院外死亡（1.08; 1.02-1.13）的相关性更强。使用NO2暴露在第一次事件的时间，有没有相关的空气污染暴露与随后的再次入院或死亡率之间的幸存者的第一冠状动脉events.Conclusions：长期的空气污染暴露增加冠心病的风险，特别是致命的事件。幸存者的再入院或随后的死亡率与交通空气污染无关。
Background: Long-term air pollution exposure is associated with increased mortality, but the association with incidence of fatal and nonfatal coronary heart disease is less certain. Moreover, it is unknown how chronic exposure to air pollution affects prognosis among survivors of a first coronary event. This study evaluated the association between long-term traffic-related air pollution exposure and incidence of nonfatal and fatal coronary events, as well as subsequent hospital readmission and mortality among myocardial infarction survivors.Methods: The study population comprised all residents of Rome aged 35-84 years during the period 1998-2000. Residential nitrogen dioxide (NO2) exposure as a marker of traffic pollution was assessed by a land-use regression model in 1995-1996 (R-2 = 0.69). A total of 11,167 incident coronary events were observed (4654 fatal, including 3598 out-of-hospital coronary deaths, and 6513 nonfatal). The cohort of 6513 survivors was followed 4.0-7.5 years for readmission or mortality, starting 28 days from the date of first event. Relative risks per 10 mu g/m(3) of NO2 exposure, adjusted for age, sex, and socioeconomic status, were calculated by Poisson regression (population-based incidence) and Cox regression (cohort analysis).Results: The relative risk for incidence in coronary events per 10 mu g/m(3) of NO2 was 1.03 (95% confidence interval = 1.00-1.07). Stronger associations were found for fatal cases (1.07; 1.02-1.12) and out-of-hospital deaths (1.08; 1.02-1.13). Using NO2 exposure at the time of the first event, there was no association of air pollution exposure with either subsequent hospital readmission or mortality among survivors of the first coronary event.Conclusions: Long-term air pollution exposure increases the risk of coronary heart disease, particularly fatal events. Hospital readmission or subsequent mortality among survivors was not associated with traffic air pollution.