空气污染与接受直接经皮冠状动脉介入治疗的ST段抬高型心肌梗死：一种直接关联。

Air pollution and ST-elevation myocardial infarction treated with primary percutaneous coronary angioplasty: A direct correlation.

作者信息

Zuin Marco, Rigatelli Gianluca, dell'Avvocata Fabio, Picariello Claudio, Conte Luca, Marcantoni Lina, Cardaioli Paolo, Zuliani Giovanni, Roncon Loris

机构信息

Division of Cardiology, Rovigo General Hospital, Rovigo, Italy; Section of Internal and Cardiopulmonary Medicine, Department of Medical Science, University of Ferrara, Ferrara, Italy.

Section of Cardiovascular Diagnosis and Endoluminal Interventions, Rovigo General Hospital, Rovigo, Italy.

出版信息

Int J Cardiol. 2017 Jun 1;236:49-53. doi: 10.1016/j.ijcard.2017.02.050. Epub 2017 Feb 16.

DOI:10.1016/j.ijcard.2017.02.050

PMID:28236545

Abstract

PURPOSE

The relationships between air pollutant concentration levels and admission for primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) have never been assessed.

METHODS

We retrospectively reviewed 4 consecutive years of medical and instrumental data (1st January 2012 to 1st March 2016) to identify patients admitted with STEMI and subsequently treated with primary PCI in our third referral center. Daily atmospheric pressure data (in hectopascal [hPa]) and air pollutant concentration levels were obtained from the regional meteorological service which had a monitoring site in our city (Rovigo, Italy). Pollutants investigated were nitrogen dioxide (NO), particulate matter ≤10μm (PM), ozone (O), sulfur dioxide (SO) and carbon monoxide (CO). Safety air concentration levels for the air pollutants were also considered.

RESULTS

PCI in STEMI patients was more frequent when AP was higher than 1013.15hPa (61.8% vs 38.2%, p<0.001). The incidences of STEMI patients when NO, PM and O levels overcame the safe threshold were 83.1%, 52% and 8.5%, respectively. A positive correlation was found between the daily number of STEMI subsequently treated with primary PCI and the air pollutant levels of the same day for NO (r=0.205, p=0.001), PM (r=0.349, p<0.0001) and O (r=0.191, p=0.002).

CONCLUSIONS

A direct and significant correlation exists between the number of daily STEMI patients and the NO, PM and O air concentration levels of the same day.

摘要

目的

从未评估过空气污染物浓度水平与ST段抬高型心肌梗死（STEMI）患者接受直接经皮冠状动脉介入治疗（PCI）之间的关系。

方法

我们回顾性分析了连续4年（2012年1月1日至2016年3月1日）的医疗和仪器数据，以确定在我们的三级转诊中心因STEMI入院并随后接受直接PCI治疗的患者。每日大气压力数据（以百帕[hPa]为单位）和空气污染物浓度水平来自在我们城市（意大利罗维戈）设有监测点的地区气象服务机构。所研究的污染物为二氧化氮（NO）、≤10μm颗粒物（PM）、臭氧（O）、二氧化硫（SO）和一氧化碳（CO）。还考虑了空气污染物的安全浓度水平。

结果

当大气压力高于1013.15hPa时，STEMI患者接受PCI的频率更高（61.8%对38.2%，p<0.001）。当NO、PM和O水平超过安全阈值时，STEMI患者的发生率分别为83.1%、52%和8.5%。在随后接受直接PCI治疗的STEMI每日例数与同一天的NO（r=0.205，p=0.001）、PM（r=0.349，p<0.0001）和O（r=0.191，p=0.002）空气污染物水平之间发现正相关。