Particulate Air Pollution and Acute Ischemic Stroke

描述(申请人提供)：在美国，中风是导致长期残疾的主要原因，也是第三大致死原因。确定中风的诱因具有重大的公共卫生利益。颗粒物污染的短期增加可能会导致急性缺血性中风，但之前的研究结果并不一致。这项建议将应用病例交叉方法来研究被诊断为急性缺血性中风的住院患者。具体地说，我们将测试以下假设：环境中颗粒物水平的短期增加会引发急性缺血性中风；当使用关于症状开始时间的准确信息时，这种影响的程度将比以前观察到的更大；颗粒物的影响将因中风的病因亚型而异，在动脉粥样硬化血栓形成和腔隙性中风的患者中观察到的风险增加最大。这些假设将在具有互补优势的患者群体中进行测试。

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.