Particulate Air Pollution and Acute Ischemic Stroke

描述（由申请人提供）：中风是美国长期残疾的主要原因，也是第三大死亡原因。确定中风的触发因素具有重大的公共卫生利益。空气微粒污染的短期增加可能导致急性缺血性中风，但之前的研究结果并不一致。本建议将病例交叉方法应用于诊断为急性缺血性脑卒中住院患者的研究。具体来说，我们将测试以下假设：环境颗粒水平的短期增加会引发急性缺血性中风；当使用有关症状发作时间的准确信息时，这种影响的程度将比以前观察到的更大；颗粒物质的影响因卒中的病因亚型而异，其中动脉粥样硬化性血栓性卒中和腔隙性卒中患者的风险增加最大。这些假设将在具有互补优势的患者群体中进行检验。

DESCRIPTION (provided by applicant): Stroke is a leading cause of long-term disability and the third leading cause of death in the US. The identification of triggers of stroke is of significant public health interest. Short-term increases in particulate air pollution may precipitate acute ischemic stroke, but previous findings have been inconsistent. This proposal will apply case-crossover methods to the study of patients hospitalized with a diagnosis of acute ischemic stroke. Specifically, we will test the hypotheses that: short-term increases in ambient particle levels can trigger acute ischemic stroke; the magnitude of this effect will be greater than previously observed when accurate information on time of symptom onset is used; and the effect of particulate matter will vary by the etiologic subtype of stroke with the greatest increase in risk to be observed in those patients with atherothrombotic and lacunar strokes. These hypotheses will be tested in patient populations with complimentary strengths.