Air Pollution, Coronary Events and Atherosclerotic Progression in a Susceptible Population

易感人群中的空气污染、冠状动脉事件和动脉粥样硬化进展

• 批准号: 10454154
• 负责人: Meng Wang
• 金额: $ 29.21万
• 依托单位: STATE UNIVERSITY OF NEW YORK AT BUFFALO
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-07-21 至 2026-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10454154
• 关键词: 12-HETE; Address; Age; Air; Air Pollutants; Air Pollution; Algorithms; American; Angiography; Arterial Fatty Streak; Atherosclerosis; Biological; Biological Markers; Biological Process; Biometry; Blood; Blood Vessels; Caliber; Carbon Black; Cardiovascular system; Caring; Cause of Death; Cessation of life; China; Clinic Visits; Clinical Management; Clinical assessments; Coronary; Coronary Arteriosclerosis; Coronary Stenosis; Coronary heart disease; Data; Development; Disease; Disease Progression; Environmental Exposure; Environmental Risk Factor; Epidemiology; Exposure to; Fatty acid glycerol esters; Functional disorder; Health Benefit; Health Policy; Health protection; Imaging technology; Individual; Indoor Air Pollution; Inflammation; Intervention; Joints; Knowledge; Lipid Peroxidation; Lipids; Longitudinal cohort study; Measures; Mediating; Modality; Modeling; Morbidity - disease rate; Morphology; Nitrogen Oxides; Noise; Outcome; Oxidative Stress; Ozone; Participant; Particle Size; Particulate Matter; Pathway interactions; Patients; Play; Policies; Pollution; Population; Prevention; Public Health; Public Policy; Regulation; Risk; Role; Rupture; Site; Source; Stenosis; Thrombosis; Time; Toxic effect; X-Ray Computed Tomography; ambient air pollution; attenuation; calcification; cardiovascular health; clinical biomarkers; coarse particles; cohort; cooking; coronary calcium scoring; coronary event; critical period; evidence base; experience; fine particles; high risk; improved; indexing; indoor pollutant; inflammatory marker; insight; interest; mortality; multidisciplinary; novel; novel marker; novel strategies; phenotypic data; population based; public health priorities; response; solid fuel; specific biomarkers; stressor; ultrafine particle; vascular inflammation

Abstract Cardiovascular health is a global public health priority. Atherosclerosis is the most common form of coronary heart diseases (CHD) which constitutes 17.5 million deaths worldwide annually. Globally, both outdoor and indoor air pollutants are known as major contributors to the burdens of CHD. Despite population-based evidence suggesting that exposure to ambient air pollutants and use of solid fuel for cooking causes increased mortality from CHD, there is little known about the impact of air pollution on CHD morbidity and progression. For example, the extent to which exposure to air pollution accelerates atherosclerosis, initiate plaque instability to rupture and develop coronary events, and the mechanistic pathways underneath are largely unknown. A better understanding of air pollutants as potential factors to the development and progression of this pervasive disease will be valuable for public health protection strategies, especially for susceptible population such as patients with atherosclerosis. Here we propose a longitudinal cohort study and present an overarching hypothesis that long-term exposure to air pollutants alter coronary biological process, accelerate disease progression, and contribute to CHD morbidity and mortality. This study builds upon a well-selected 3500 patients with atherosclerosis in Beijing retrieved from an existing cohort and will add two waves of clinic visits in 1100 subpopulation to examine disease progression. The cohort includes extensive data of novel subclinical markers from computed tomography angiography (CTA) reflecting plaque morphology, plaque vulnerability, vascular stenosis, and coronary inflammation, and also collects biomarkers related to their mechanistic pathways. We also propose to add state-of-the art air pollution exposure assessment to determine individual level of outdoor and indoor air pollution exposure of the highest quality to address our study hypotheses. Firstly, we will determine the impact of outdoor and indoor air pollution exposures on coronary events and total cardiovascular mortality. Secondly, we will investigate the effects of exposure to air pollution on atherosclerosis progression and high-risk plaque formation characterized by CTA outcomes. Thirdly, we will examine the effects of air pollution on biological markers of inflammation pathways and explore whether these pathways mediate any response of disease progression to air pollution exposure. Lastly, we will take the unique opportunity of the most stringent regulation period on air pollution in Beijing and assess whether long-term decline in ambient air pollution change the worsening of the disease progression and biological responses as our secondary hypothesis. Apart from the main analysis, we will also explore the potential of joint effects of air pollutant mixtures and independent effects of air pollution exposure from traffic noise on CHD. Findings from this study will not only extend scientific knowledge on air pollution and CHD physiopathology, but will provide information to guide public policy and inform clinical management for individuals at-risk of CHD.

抽象的 心血管健康是全球公共卫生的优先事项。动脉粥样硬化是冠状动脉最常见的形式 心脏病 (CHD) 每年导致全球 1750 万人死亡。在全球范围内，无论是户外还是 室内空气污染物被认为是导致冠心病负担的主要因素。尽管以人口为基础 有证据表明，接触环境空气污染物和使用固体燃料做饭会导致 尽管空气污染对冠心病发病和进展的影响知之甚少。 例如，接触空气污染会加速动脉粥样硬化，引发斑块不稳定 破裂并发生冠状动脉事件，其背后的机制途径在很大程度上尚不清楚。一个 更好地了解空气污染物作为这一普遍存在的发展和进展的潜在因素 疾病对于公共卫生保护策略将很有价值，特别是对于易感人群，例如 动脉粥样硬化患者。在这里，我们提出了一项纵向队列研究，并提出了一个总体 假设长期接触空气污染物会改变冠状动脉的生物过程，加速疾病的发生 进展，并导致 CHD 发病率和死亡率。这项研究建立在精心挑选的 3500 北京动脉粥样硬化患者从现有队列中检索，将增加两波就诊 在 1100 个亚群中检查疾病进展。该队列包括新型亚临床的大量数据 来自计算机断层扫描血管造影 (CTA) 的标记反映了斑块形态、斑块脆弱性、 血管狭窄和冠状动脉炎症，并收集与其机制相关的生物标志物 途径。我们还建议添加最先进的空气污染暴露评估，以确定个人 最高质量的室外和室内空气污染暴露水平来解决我们的研究假设。 首先，我们将确定室外和室内空气污染暴露对冠状动脉事件和总冠状动脉事件的影响。 心血管死亡率。其次，我们将研究暴露于空气污染对动脉粥样硬化的影响 以 CTA 结果为特征的进展和高风险斑块形成。第三，我们将检查 空气污染对炎症途径生物标志物的影响，并探讨这些途径是否 介导疾病进展对空气污染暴露的任何反应。最后，我们将采取独特的 抓住北京空气污染最严整治期的机遇，并评估是否长期有效 环境空气污染的减少改变了疾病进展和生物反应的恶化 our secondary hypothesis.除了主要分析外，我们还将探讨空气联合效应的潜力 污染物混合物以及交通噪音造成的空气污染暴露对冠心病的独立影响。调查结果来自 这项研究不仅将扩展有关空气污染和冠心病病理生理学的科学知识，还将提供 指导公共政策并为有先心病风险的个人的临床管理提供信息。