Myocardial infarction, ST-elevation and non-ST-elevation myocardial infarction and modelled daily pollution concentrations: a case-crossover analysis of MINAP data.
Myocardial infarction, ST-elevation and non-ST-elevation myocardial infarction and modelled daily pollution concentrations: a case-crossover analysis of MINAP data.
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DOI：
10.1136/openhrt-2016-000429
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发表时间：
2016
期刊：
影响因子：
2.7
通讯作者：
Wilkinson P
中科院分区：
文献类型：
--
作者：
Butland BK;Atkinson RW;Milojevic A;Heal MR;Doherty RM;Armstrong BG;MacKenzie IA;Vieno M;Lin C;Wilkinson P
探讨空气污染日浓度与心肌梗死(MI)、ST段抬高MI(STEMI)和非ST段抬高MI(NSTEMI)的关系。模拟的每日地面气态、总和形态颗粒污染物浓度以及地面日平均温度，均在5 公里×5 公里的水平分辨率下，与英格兰和威尔士心肌梗死国家审计项目数据库中记录的202STEMI 550STEMI和322NSTEMI事件有关。研究时间为2003-2010年。采用病例交叉设计，按年份、月份和星期几分层。数据用条件Logistic回归进行分析，污染物模型为无约束分布滞后0-2 天。结果以污染物相关指标每增加10 微克/立方米的风险变化百分比表示，已根据日平均气温、公众假期、每周流感就诊率和正弦余弦年度周期进行调整。没有证据表明MI或STEMI与臭氧、NO2、PM2.5、PM10或选定的PM2.5成分(硫酸盐和元素碳)中的任何一种有关。对于NSTEMI，与每日最大1小时NO2呈正相关(0.27%(95%CI 0.01%至0.54%))，在调整臭氧和PM2.5后持续存在。该协会似乎仅限于英格兰中部以及英格兰和威尔士的南部地区。这项研究没有发现被调查的模拟污染物(包括成分)与STEMI之间存在关联的证据，但确实发现了一些NO2和NSTEMI之间存在正相关的证据。需要在其他研究中确认这种关联。
To investigate associations between daily concentrations of air pollution and myocardial infarction (MI), ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI). Modelled daily ground-level gaseous, total and speciated particulate pollutant concentrations and ground-level daily mean temperature, all at 5 km×5 km horizontal resolution, were linked to 202 550 STEMI and 322 198 NSTEMI events recorded on the England and Wales Myocardial Ischaemia National Audit Project (MINAP) database. The study period was 2003–2010. A case-crossover design was used, stratified by year, month and day of the week. Data were analysed using conditional logistic regression, with pollutants modelled as unconstrained distributed lags 0–2 days. Results are presented as percentage change in risk per 10 µg/m3 increase in the pollutant relevant metric, having adjusted for daily mean temperature, public holidays, weekly influenza consultation rates and a sine-cosine annual cycle. There was no evidence of an association between MI or STEMI and any of O3, NO2, PM2.5, PM10 or selected PM2.5 components (sulfate and elemental carbon). For NSTEMI, there was a positive association with daily maximum 1-hour NO2 (0.27% (95% CI 0.01% to 0.54%)), which persisted following adjustment for O3 and adjustment for PM2.5. The association appeared to be confined to the midland and southern regions of England and Wales. The study found no evidence of an association between the modelled pollutants (including components) investigated and STEMI but did find some evidence of a positive association between NO2 and NSTEMI. Confirmation of this association in other studies is required.