World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, 42-09 28th Street, Long Island City, NY 11101, USA.
Prev Med. 2011 Dec;53(6):370-6. doi: 10.1016/j.ypmed.2011.10.014. Epub 2011 Oct 28.
To examine associations between 9/11-related exposures, posttraumatic stress disorder (PTSD), and subsequent development of heart disease (HD).
We prospectively followed 39,324 WTC Health Registry participants aged ≥18 on 9/11 for an average of 2.9 years. HD was defined as self-reported physician-diagnosed angina, heart attack, and/or other HD reported between study enrollment (2003-2004) and a follow-up survey (2006-2008) in enrollees without previous HD. A PTSD Checklist (PCL) score ≥44 was considered PTSD. We calculated adjusted hazard ratios (AHR) and 95% confidence intervals (CI) to examine relationships between 9/11-related exposures and HD.
We identified 1162 HD cases (381 women, 781 men). In women, intense dust cloud exposure was significantly associated with HD (AHR 1.28, 95% CI 1.02-1.61). Injury on 9/11 was significantly associated with HD in women (AHR 1.46, 95% CI 1.19-1.79) and in men (AHR 1.33, 95% CI 1.15-1.53). Participants with PTSD at enrollment had an elevated HD risk (AHR 1.68, 95% CI 1.33-2.12 in women, AHR 1.62, 95% CI 1.34-1.96 in men). A dose-response relationship was observed between PCL score and HD risk.
This exploratory study suggests that exposure to the WTC dust cloud, injury on 9/11 and 9/11-related PTSD may be risk factors for HD.
探讨 9·11 相关暴露、创伤后应激障碍（PTSD）与随后发生心脏病（HD）之间的关系。
我们前瞻性地随访了 39324 名年龄≥18 岁的 WTC 健康登记参与者，平均随访 2.9 年。HD 的定义为自我报告的医生诊断的心绞痛、心脏病发作和/或其他 HD，这些疾病是在登记时（2003-2004 年）无既往 HD 的登记参与者的后续调查（2006-2008 年）期间报告的。PTSD 检查清单（PCL）得分≥44 被认为是 PTSD。我们计算了调整后的危险比（AHR）和 95%置信区间（CI），以检验 9/11 相关暴露与 HD 之间的关系。
我们确定了 1162 例 HD 病例（381 例女性，781 例男性）。在女性中，强烈的尘云暴露与 HD 显著相关（AHR 1.28，95%CI 1.02-1.61）。9/11 日受伤与女性（AHR 1.46，95%CI 1.19-1.79）和男性（AHR 1.33，95%CI 1.15-1.53）的 HD 显著相关。登记时患有 PTSD 的参与者发生 HD 的风险增加（女性 AHR 1.68，95%CI 1.33-2.12，男性 AHR 1.62，95%CI 1.34-1.96）。PCL 评分与 HD 风险之间存在剂量-反应关系。
这项探索性研究表明，接触 WTC 尘云、9/11 日受伤和与 9/11 相关的 PTSD 可能是 HD 的危险因素。
