Effect of Ambient Particles on Acute Stroke Onset

环境颗粒物对急性中风发作的影响

• 批准号: 6939093
• 负责人: MURRAY A MITTLEMAN
• 金额: $ 21.58万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6939093
• 关键词: air pollution; air sampling /monitoring; cardiovascular disorder epidemiology; cardiovascular disorder risk; clinical research; disease /disorder onset; environmental exposure; human subject; nervous system disorder epidemiology; particle; stroke

Stroke is a leading cause of long-term disability in the US and the third leading cause of death after heart disease and cancer. The identification of triggers of stroke onset is of significant public health interest. Many epidemiologic studies have found an association between short-term increases in particulate air pollution and cardiovascular morbidity and mortality. These effects are likely mediated by neural, hematologic, and inflammatory responses to inhaled particles. Exposure to particulate matter may also increase the risk of ischemic stroke. Recent studies using administrative databases have reported equivical results. Accordingly, the goal of this Project is to quantitatively evaluate the association between short-term increases in ambient particulate matter and the risk of acute ischemic stroke. Specifically, we will evaluate: 1) the association between short-term increases in particulate matter and the risk of acute ischemic stroke, 2) the time course of this effect, 3) the specific constituents of ambient particulate matter to which the effect is most likely attributable, and 4) variation in effect magnitude by etiological subtype of ischemic stroke. To accomplish these aims we will use the services and expertise of the PPG Cores and will apply the case-crossover methodology to the study of 1200 patients hospitalized with acute ischemic stroke. Even though the magnitude of any effect is expected to be small, given the large number of people simultaneously at risk for stroke and exposed to urban air pollution, the attributable risk may be quite significant. Clarifying the impact of particulate air pollution on stroke onset is important for regulatory agencies. Additionally, information about the time course of the effect and identification of important particle constituents may provide insight into the mechanisms of particulate-induced cardiovascular events.

在美国，中风是导致长期残疾的主要原因，也是继心脏病和癌症之后的第三大致死原因。卒中发病诱因的确定具有重大的公共卫生意义。许多流行病学研究发现，颗粒物空气污染的短期增加与心血管发病率和死亡率之间存在关联。这些影响可能是通过对吸入颗粒物的神经、血液学和炎症反应来调节的。暴露在颗粒物中也可能增加缺血性中风的风险。最近使用行政数据库进行的研究报告了相同的结果。因此，该项目的目标是定量评估环境颗粒物短期增加与急性缺血性中风风险之间的关联。具体来说， 我们将评估：1)颗粒物短期增加与急性缺血性中风风险之间的联系，2)这种效应的时间进程，3)这种效应最有可能归因于的周围颗粒物的特定成分，以及4)缺血性中风不同病因亚型的效应大小的变化。为了实现这些目标，我们将利用PPG核心的服务和专业知识，并将采用病例交叉方法对1200名急性缺血性中风住院患者进行研究。尽管预计任何影响的幅度都很小，但考虑到大量同时面临中风风险和暴露在城市空气污染中的人，可归因性风险可能相当大。澄清颗粒物空气污染对中风发病的影响对监管机构来说很重要。此外，有关重要颗粒的影响和识别的时间进程的信息 成分可以提供对颗粒物引起的心血管事件的机制的洞察。