Ambient Fine Particulate Matter and Mortality among Survivors of Myocardial Infarction: Population-Based Cohort Study.
Ambient Fine Particulate Matter and Mortality among Survivors of Myocardial Infarction: Population-Based Cohort Study.
复制标题
DOI：
10.1289/ehp185
复制
发表时间：
2016-09
影响因子：
10.4
通讯作者：
Tu JV
中科院分区：
文献类型：
--
作者：
Chen H;Burnett RT;Copes R;Kwong JC;Villeneuve PJ;Goldberg MS;Brook RD;van Donkelaar A;Jerrett M;Martin RV;Brook JR;Kopp A;Tu JV
急性心肌梗死（AMI）的幸存者在暴露于高水平的环境空气污染后数小时至数天内死亡的风险增加。然而，关于长期（数月至数年）空气污染暴露对AMI后生存率的影响知之甚少。我们进行了一项基于人群的队列研究，以确定长期暴露于直径≤ 2.5 μm的细颗粒物（PM2.5）对AMI后生存率的影响。我们收集了一组8，873名AMI患者，他们在1999-2001年间入住加拿大安大略的86家医院公司之一。该队列的死亡率随访延长至2011年。PM2.5的累积时间加权暴露量来自于基于参与者在随访期间的年度居住地的卫星观测。我们使用标准和多水平空间随机效应考克斯比例风险模型，并调整潜在的混杂因素。在1999年至2011年期间，我们确定了4，016例非意外死亡，其中2，147例死于任何心血管疾病，1，650例死于缺血性心脏病，675例死于AMI。PM2.5每增加10 μg/m3，非意外死亡的校正风险比（HR 10）为1.22 [95%置信区间（CI）：1.03，1.45]。与PM2.5的相关性对于敏感性分析是稳健的，并且对于心血管相关死亡率似乎更强：缺血性心脏（HR 10 = 1.43; 95% CI：1.12，1.83）和AMI（HR 10 = 1.64; 95% CI：1.13，2.40）。我们估计，如果在研究过程中所有地点都达到城市地区的最低测量浓度（4 μg/m3），则可以避免12.4%的非意外死亡（或497例死亡）。长期空气污染暴露对AMI患者的生存有不利影响。Chen H，Burnett RT，Copes R，Kwong JC，维勒纳夫PJ，Goldberg MS，Brook RD，货货车Donkelaar A，Jerrett M，Martin RV，Brook JR，Kopp A，Tu JV. 2016.心肌梗死幸存者周围细颗粒物与死亡率：基于人群的队列研究环境健康展望124：1421-1428; http：dx.doi.org/10.1289/EHP185
Survivors of acute myocardial infarction (AMI) are at increased risk of dying within several hours to days following exposure to elevated levels of ambient air pollution. Little is known, however, about the influence of long-term (months to years) air pollution exposure on survival after AMI. We conducted a population-based cohort study to determine the impact of long-term exposure to fine particulate matter ≤ 2.5 μm in diameter (PM2.5) on post-AMI survival. We assembled a cohort of 8,873 AMI patients who were admitted to 1 of 86 hospital corporations across Ontario, Canada in 1999–2001. Mortality follow-up for this cohort extended through 2011. Cumulative time-weighted exposures to PM2.5 were derived from satellite observations based on participants’ annual residences during follow-up. We used standard and multilevel spatial random-effects Cox proportional hazards models and adjusted for potential confounders. Between 1999 and 2011, we identified 4,016 nonaccidental deaths, of which 2,147 were from any cardiovascular disease, 1,650 from ischemic heart disease, and 675 from AMI. For each 10-μg/m3 increase in PM2.5, the adjusted hazard ratio (HR10) of nonaccidental mortality was 1.22 [95% confidence interval (CI): 1.03, 1.45]. The association with PM2.5 was robust to sensitivity analyses and appeared stronger for cardiovascular-related mortality: ischemic heart (HR10 = 1.43; 95% CI: 1.12, 1.83) and AMI (HR10 = 1.64; 95% CI: 1.13, 2.40). We estimated that 12.4% of nonaccidental deaths (or 497 deaths) could have been averted if the lowest measured concentration in an urban area (4 μg/m3) had been achieved at all locations over the course of the study. Long-term air pollution exposure adversely affects the survival of AMI patients. Chen H, Burnett RT, Copes R, Kwong JC, Villeneuve PJ, Goldberg MS, Brook RD, van Donkelaar A, Jerrett M, Martin RV, Brook JR, Kopp A, Tu JV. 2016. Ambient fine particulate matter and mortality among survivors of myocardial infarction: population-based cohort study. Environ Health Perspect 124:1421–1428; http://dx.doi.org/10.1289/EHP185