Asian dust exposure triggers acute myocardial infarction
Asian dust exposure triggers acute myocardial infarction
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DOI：
10.1093/eurheartj/ehx509
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发表时间：
2017-11-14
影响因子：
39.3
通讯作者：
Takami, Akinori
中科院分区：
文献类型：
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作者：
Kojima, Sunao;Michikawa, Takehiro;Takami, Akinori
为了阐明亚洲粉尘是否与急性心肌梗死(AMI)的发病率有关，以及对亚洲粉尘高度敏感的患者是否会患上急性心肌梗死，这项研究纳入了熊本县21家能够进行冠状动脉介入治疗的参与机构。亚洲沙尘事件的地面观测数据是在熊本地方气象台测量的。对2010年4月1日至2015年3月31日收集的数据进行分析，纳入连续3713例急性心肌梗死患者。采用时间分层病例交叉设计来检验亚洲粉尘暴露与急性心肌梗死之间的关系。发病前1天发生亚洲粉尘事件与急性心肌梗死的发病相关[优势比(OR)1.46；95%可信区间(CI)1.09~1.95]，尤其是非ST段抬高心肌梗死(OR 2.03；95%CI，1.30~3.15)。在75岁、男性、高血压、糖尿病、从不吸烟和慢性肾脏疾病(CKD)的患者中，观察到急性心肌梗死与亚洲粉尘显著相关。然而，亚洲粉尘事件对慢性肾脏病患者急性心肌梗死的发病有很大影响(P<；0.01)。开发了一种计入几个急性心肌梗死危险因素的评分系统。亚洲沙尘事件的发生与危险评分为5~6分的患者发生急性心肌梗死显著相关(OR 2.45；95%CI：1.14~5.27)。亚洲沙尘事件可能导致急性心肌梗死，并对慢性肾脏病患者的发病有很大影响。
To elucidate whether Asian dust is associated with the incidence of acute myocardial infarction (AMI) and to clarify whether patients who are highly sensitive to Asian dust will develop AMI.Twenty-one participating institutions located throughout Kumamoto Prefecture and capable of performing coronary intervention were included in the study. Data for ground-level observations of Asian dust events were measured at the Kumamoto Local Meteorological Observatory. Data collected between 1 April 2010 and 31 March 2015 were analysed, and 3713 consecutive AMI patients were included. A time-stratified case-crossover design was applied to examine the association between Asian dust exposure and AMI. The occurrence of Asian dust events at 1 day before the onset of AMI was associated with the incidence of AMI [odds ratio (OR), 1.46; 95% confidence interval (CI), 1.09-1.95] and especially, non-ST-segment elevation myocardial infarction was significant (OR 2.03; 95% CI, 1.30-3.15). A significant association between AMI and Asian dust was observed in patients with age 75 years, male sex, hypertension, diabetes mellitus, never-smoking status, and chronic kidney disease (CKD). However, Asian dust events had a great impact on AMI onset in patients with CKD (P < 0.01). A scoring system accounting for several AMI risk factors was developed. The occurrence of Asian dust events was found to be significantly associated with AMI incidence among patients with a risk score of 5-6 (OR 2.45; 95% CI: 1.14-5.27).Asian dust events may lead to AMI and have a great impact on its onset in patients with CKD.