Heart disease among adults exposed to the September 11, 2001 World Trade Center disaster: Results from the World Trade Center Health Registry
Heart disease among adults exposed to the September 11, 2001 World Trade Center disaster: Results from the World Trade Center Health Registry
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DOI：
10.1016/j.ypmed.2011.10.014
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发表时间：
2011-12-01
影响因子：
5.1
通讯作者：
Stellman, Steven D.
中科院分区：
文献类型：
--
作者：
Jordan, Hannah T.;Miller-Archie, Sara A.;Stellman, Steven D.
Objective.研究9/11相关暴露、创伤后应激障碍（PTSD）和随后心脏病（HD）发展之间的关系。我们前瞻性地随访了39，324名在9/11中年龄≥ 18岁的WTC健康注册参与者，平均随访时间为2.9年。HD定义为在研究入组（2003-2004年）和随访调查（2006-2008年）期间，在既往无HD的入组者中自我报告的医生诊断的心绞痛、心脏病发作和/或其他HD。PTSD检查表（PCL）评分>= 44被认为是PTSD。我们计算了调整后的风险比（AHR）和95%置信区间（CI），以检查9/11相关暴露与HD之间的关系。我们确定了1162例HD病例（381例女性，781例男性）。在女性中，强烈的粉尘云暴露与HD显著相关（AHR 1.28，95% CI 1.02-1.61）。在女性（AHR 1.46，95% CI 1.19-1.79）和男性（AHR 1.33，95% CI 1.15-1.53）中，9/11的损伤与HD显著相关。入选时患有PTSD的参与者HD风险升高（女性AHR 1.68，95% CI 1.33-2.12）。男性AHR 1.62，95% CI 1.34-1.96）。PCL评分与HD风险之间存在剂量-反应关系。这项探索性研究表明，暴露于世贸中心的灰尘云，9/11和9/11相关的PTSD伤害可能是HD的危险因素。(C)2011 Elsevier Inc. All rights reserved.
Objective. To examine associations between 9/11-related exposures, posttraumatic stress disorder (PTSD), and subsequent development of heart disease (HD).Methods. We prospectively followed 39,324 WTC Health Registry participants aged >= 18 on 9/11 for an average of 2.9 years. HD was defined as self-reported physician-diagnosed angina, heart attack, and/or other HD reported between study enrollment (2003-2004) and a follow-up survey (2006-2008) in enrollees without previous HD. A PTSD Checklist (PCL) score >= 44 was considered PTSD. We calculated adjusted hazard ratios (AHR) and 95% confidence intervals (CI) to examine relationships between 9/11-related exposures and HD.Results. We identified 1162 HD cases (381 women, 781 men). In women, intense dust cloud exposure was significantly associated with HD (AHR 1.28, 95% Cl 1.02-1.61). Injury on 9/11 was significantly associated with HD in women (AHR 1.46, 95% Cl 1.19-1.79) and in men (AHR 1.33, 95% Cl 1.15-1.53). Participants with PTSD at enrollment had an elevated HD risk (AHR 1.68, 95% Cl 1.33-2.12 in women. AHR 1.62, 95% Cl 1.34-1.96 in men). A dose-response relationship was observed between PCL score and HD risk.Conclusion. This exploratory study suggests that exposure to the WTC dust cloud, injury on 9/11 and 9/11-related PTSD may be risk factors for HD. (C) 2011 Elsevier Inc. All rights reserved.