基于 84 项队列研究的系统评价和荟萃分析：时间事件分析与心血管疾病和死亡率风险相关的空气污染物。

A time-to-event analysis on air pollutants with the risk of cardiovascular disease and mortality: A systematic review and meta-analysis of 84 cohort studies.

机构信息

Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia.

Department of Cardiology and Vascular Medicine, Faculty of Medicine Universitas Sriwijaya, Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia.

出版信息

J Evid Based Med. 2020 May;13(2):102-115. doi: 10.1111/jebm.12380. Epub 2020 Mar 13.

DOI:10.1111/jebm.12380

PMID:32167232

Abstract

OBJECTIVE

Air pollution is one of the most substantial problems globally. Aerodynamic toxic of particulate matter with <10 mm in diameter (PM ), or <2.5 mm (PM ), as well as nitric dioxide (NO ), have been linked with health issues. We aimed to perform a comprehensive analysis of the time-to-event for different types of air pollutants on cardiovascular disease (CVD) events based on cohort studies.

METHODS

A comprehensive search on topics that assesses air pollution and cardiovascular disease with keywords up until July 2019 was performed.

RESULTS

There were a total of 28 215 394 subjects from 84 cohorts. Increased PM was associated with composite CVD [HR 1.10 (1.02, 1.19)], acute coronary events [HR 1.15 (1.12, 1.17)], stroke [HR 1.13 (1.06, 1.19)], and hypertension [HR 1.07 (1.01, 1.14)], all-cause mortality [HR 1.07 (1.04, 1.09)], CVD mortality [HR 1.10 (1.07, 1.12)], and ischemic heart disease (IHD) mortality [HR 1.11 (1.07, 1.16)]. Association with AF became significant after removal of a study. Increased PM was associated with heart failure [HR 1.25 (1.04, 1.50)], all-cause mortality [HR 1.16 (1.06, 1.27)], CVD mortality [HR 1.17 (1.04, 1.30)], and IHD mortality [HR 1.03 (1.01, 1.05)]. Increased of NO was associated with increased composite CVD [HR 1.15 (1.02, 1.29)], atrial fibrillation [HR 1.01 (1.01, 1.02)], acute coronary events [HR 1.08 (1.02, 1.13)], all-cause mortality [HR 1.23 (1.14, 1.32)], CVD mortality [HR 1.17 (1.10, 1.25)], and IHD mortality [HR 1.05 (1.03, 1.08)].

CONCLUSION

Air pollutants are associated with an increased incidence of cardiovascular diseases, all-cause mortality, and CVD mortality.

摘要

目的

空气污染是全球面临的最重大问题之一。直径小于 10 毫米（PM10）或小于 2.5 毫米（PM2.5）的颗粒物以及二氧化氮（NO）的空气动力学毒性与健康问题有关。我们旨在根据队列研究，对不同类型的空气污染物对心血管疾病（CVD）事件的时间到事件进行全面分析。

方法

我们对截至 2019 年 7 月评估空气污染和心血管疾病的主题进行了全面检索，并使用了关键词。

结果

共有 84 项队列研究中的 28215394 名受试者。PM 增加与复合 CVD[HR 1.10（1.02，1.19）]、急性冠状动脉事件[HR 1.15（1.12，1.17）]、中风[HR 1.13（1.06，1.19）]、高血压[HR 1.07（1.01，1.14）]、全因死亡率[HR 1.07（1.04，1.09）]、CVD 死亡率[HR 1.10（1.07，1.12）]和缺血性心脏病（IHD）死亡率[HR 1.11（1.07，1.16）]相关。AF 与 PM 之间的关联在去除一项研究后变得显著。PM 增加与心力衰竭[HR 1.25（1.04，1.50）]、全因死亡率[HR 1.16（1.06，1.27）]、CVD 死亡率[HR 1.17（1.04，1.30）]和 IHD 死亡率[HR 1.03（1.01，1.05）]相关。NO 的增加与复合 CVD[HR 1.15（1.02，1.29）]、心房颤动[HR 1.01（1.01，1.02）]、急性冠状动脉事件[HR 1.08（1.02，1.13）]、全因死亡率[HR 1.23（1.14，1.32）]、CVD 死亡率[HR 1.17（1.10，1.25）]和 IHD 死亡率[HR 1.05（1.03，1.08）]的增加相关。