在欧洲五个城市，环境空气污染与心肌梗死幸存者再次入院治疗心脏病的风险增加有关。

Ambient air pollution is associated with increased risk of hospital cardiac readmissions of myocardial infarction survivors in five European cities.

作者信息

von Klot Stephanie, Peters Annette, Aalto Pasi, Bellander Tom, Berglind Niklas, D'Ippoliti Daniela, Elosua Roberto, Hörmann Allmut, Kulmala Markku, Lanki Timo, Löwel Hannelore, Pekkanen Juha, Picciotto Sally, Sunyer Jordi, Forastiere Francesco

机构信息

Institute of Epidemiology, GSF-National Research Center for Environment and Health, Neuherberg, Germany.

出版信息

Circulation. 2005 Nov 15;112(20):3073-9. doi: 10.1161/CIRCULATIONAHA.105.548743.

DOI:10.1161/CIRCULATIONAHA.105.548743

PMID:16286602

Abstract

BACKGROUND

Ambient air pollution has been associated with increases in acute morbidity and mortality. The objective of this study was to evaluate the short-term effects of urban air pollution on cardiac hospital readmissions in survivors of myocardial infarction, a potentially susceptible subpopulation.

METHODS AND RESULTS

In this European multicenter cohort study, 22,006 survivors of a first myocardial infarction were recruited in Augsburg, Germany; Barcelona, Spain; Helsinki, Finland; Rome, Italy; and Stockholm, Sweden, from 1992 to 2000. Hospital readmissions were recorded in 1992 to 2001. Ambient nitrogen dioxide, carbon monoxide, ozone, and mass of particles <10 microm (PM10) were measured. Particle number concentrations were estimated as a proxy for ultrafine particles. Short-term effects of air pollution on hospital readmissions for myocardial infarction, angina pectoris, and cardiac causes (myocardial infarction, angina pectoris, dysrhythmia, or heart failure) were studied in city-specific Poisson regression analyses with subsequent pooling. During follow-up, 6655 cardiac readmissions were observed. Cardiac readmissions increased in association with same-day concentrations of PM10 (rate ratio [RR] 1.021, 95% CI 1.004 to 1.039) per 10 microg/m3) and estimated particle number concentrations (RR 1.026 [95% CI 1.005 to 1.048] per 10,000 particles/cm3). Effects of similar strength were observed for carbon monoxide (RR 1.014 [95% CI 1.001 to 1.026] per 200 microg/m3 [0.172 ppm]), nitrogen dioxide (RR 1.032 [95% CI 1.013 to 1.051] per 8 microg/m3 [4.16 ppb]), and ozone (RR 1.026 [95% CI 1.001 to 1.051] per 15 microg/m3 [7.5 ppb]). Pooled effect estimates for angina pectoris and myocardial infarction readmissions were comparable.

CONCLUSIONS

The results suggest that ambient air pollution is associated with increased risk of hospital cardiac readmissions of myocardial infarction survivors in 5 European cities.

摘要

背景

环境空气污染与急性发病率和死亡率的增加有关。本研究的目的是评估城市空气污染对心肌梗死幸存者心脏再入院的短期影响，这是一个潜在的易感亚人群。

方法与结果

在这项欧洲多中心队列研究中，1992年至2000年期间，在德国奥格斯堡、西班牙巴塞罗那、芬兰赫尔辛基、意大利罗马和瑞典斯德哥尔摩招募了22006名首次心肌梗死的幸存者。记录了1992年至2001年的医院再入院情况。测量了环境二氧化氮、一氧化碳、臭氧和直径小于10微米的颗粒物（PM10）质量。估计颗粒物数量浓度作为超细颗粒物的替代指标。在特定城市的泊松回归分析及随后的汇总分析中，研究了空气污染对心肌梗死、心绞痛和心脏病因（心肌梗死、心绞痛、心律失常或心力衰竭）导致的医院再入院的短期影响。在随访期间，观察到6655例心脏再入院病例。心脏再入院率与当日PM10浓度（每10微克/立方米的率比[RR]为1.021，95%可信区间为1.004至1.039）和估计的颗粒物数量浓度（每10000个颗粒/立方厘米的RR为1.026[95%可信区间为1.005至1.048]）相关。一氧化碳（每200微克/立方米[0.172 ppm]的RR为1.014[95%可信区间为1.001至1.026]）、二氧化氮（每8微克/立方米[4.16 ppb]的RR为1.032[95%可信区间为1.013至1.051]）和臭氧（每15微克/立方米[7.5 ppb]的RR为1.026[95%可信区间为1.001至1.051]）也观察到了类似强度的影响。心绞痛和心肌梗死再入院的汇总效应估计值相当。