Air pollution and ST-elevation myocardial infarction: A case-crossover study of the Belgian STEMI registry 2009-2013
Air pollution and ST-elevation myocardial infarction: A case-crossover study of the Belgian STEMI registry 2009-2013
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DOI：
10.1016/j.ijcard.2016.07.191
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发表时间：
2016-11-15
影响因子：
3.5
通讯作者：
Claeys, M. J.
中科院分区：
文献类型：
--
作者：
Argacha, J. F.;Collart, P.;Claeys, M. J.
背景：先前的研究表明，空气污染颗粒物（PM）与心肌梗死风险增加有关。空气污染对 ST 段抬高型心肌梗死 (STEMI) 风险的影响，特别是 NO2 和 O-3 等气态空气污染物的作用以及特定人群的易感性，仍在争论中。 方法：纳入 2009 年至 2013 年间进入比利时前瞻性 STEMI 登记的所有患者。根据比利时环境署经过验证的空间插值模型，使用国家指数来确定比利时人口空气污染暴露的背景水平。对 STEMI 风险进行时间分层和温度匹配的病例交叉分析。结果：本研究共纳入 11,428 名 STEMI 患者。 PM10、PM2.5 和 NO2 每增加 10 μg/m(3)，STEMI 的优势比 (OR) 就会增加，分别为 1.026（CI 95%：1.005-1.048）、1.028（CI 95%：1.003-1.054）和 1.051（CI95%：1.051）。 1.018-1.084），分别。未发现 O3 的影响。 STEMI 与 75 岁以上患者的 PM10 暴露相关。 （OR：1.046，CI95%：1.002-1.092）和使用 NO2 的患者
Background: Previous studies have shown that air pollution particulate matter (PM) is associated with an increased risk for myocardial infarction. The effects of air pollution on the risk of ST-elevation myocardial infarction (STEMI), in particular the role of gaseous air pollutants such as NO2 and O-3 and the susceptibility of specific populations, are still under debate.Methods: All patients entered in the Belgian prospective STEMI registry between 2009 and 2013 were included. Based on a validated spatial interpolation model from the Belgian Environment Agency, a national index was used to address the background level of air pollution exposure of Belgian population. A time-stratified and temperature-matched case-crossover analysis of the risk of STEMI was performed.Results: A total of 11,428 STEMI patients were included in the study. Each 10 mu g/m(3) increase in PM10, PM2.5 and NO2 was associated with an increased odds ratio (ORs) of STEMI of 1.026 (CI 95%: 1.005-1.048), 1.028 (CI 95%: 1.003-1.054) and 1.051 (CI95%: 1.018-1.084), respectively. No effect of O3 was found. STEMI was associated with PM10 exposure in patients >= 75 y.o. (OR: 1.046, CI95%: 1.002-1.092) and with NO2 in patients