Department of Cardiology, Yancheng Hospital Affiliated to Xuzhou Medical University and the First Hospital of Yancheng, No. 166 Yulong West Road, Yancheng, 224006, China.
Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Environ Sci Pollut Res Int. 2021 Jun;28(21):26906-26912. doi: 10.1007/s11356-021-12428-5. Epub 2021 Jan 26.
Heart failure (HF) is a global public health problem of increasing importance. The association between acute exposure to air pollution and HF has been well established in developed countries, but little evidence is available in developing countries where air pollution levels are much higher.
To explore the associations between PM and HF hospitalizations in Yancheng, China.
In this time-series study, daily HF hospitalizations admitted in three major hospitals in Yancheng from May 1, 2015 to Apr 30, 2020 were collected. We used a generalized additive model with quasi-Poisson regression to investigate the association between PM and HF hospitalizations. The robustness of the associations was tested using two-pollutant models, and we examined the potential effect modification by age, gender, and season via stratification analyses. Lastly, we pooled the concentration-response curves.
A total of 10,466 HF hospitalizations were recorded, with a daily average of 6 cases. We observed the most robust estimates on lag 0 day, and the associated increment in HF was 1.28% (95% CI 0.45%, 2.11%) for a 10-μg/m increase of PM. The association remained after adjustment of O, but not for NO, CO, and SO. The PM-HF associations were positive in females, patients aged ≥ 65 years, and in cold season. The C-R relationship curve was generally increasing below 30 μg/m.
This study provided evidence on the association of PM with acute exacerbation of chronic heart failure, which may benefit future prevention strategy and policymaking.
心力衰竭（HF）是一个日益重要的全球公共卫生问题。在发达国家，急性暴露于空气污染与 HF 之间的关联已得到充分证实，但在空气污染水平高得多的发展中国家，证据很少。
探讨中国盐城 PM 与 HF 住院之间的关系。
在这项时间序列研究中，收集了 2015 年 5 月 1 日至 2020 年 4 月 30 日期间盐城三家主要医院收治的 HF 住院患者的每日数据。我们使用广义加性模型和拟泊松回归来研究 PM 与 HF 住院之间的关系。通过双污染物模型测试关联的稳健性，并通过分层分析检验年龄、性别和季节的潜在效应修饰作用。最后，我们汇总了浓度-反应曲线。
共记录了 10466 例 HF 住院患者，平均每天 6 例。我们在滞后 0 天观察到最稳健的估计值，PM 增加 10μg/m 时 HF 增加 1.28%（95%CI 0.45%，2.11%）。调整 O 后，这种关联仍然存在，但对 NO、CO 和 SO 没有影响。在女性、年龄≥65 岁和寒冷季节，PM 与 HF 的关联呈正相关。C-R 关系曲线在 30μg/m 以下一般呈上升趋势。
本研究提供了 PM 与慢性心力衰竭急性加重之间关联的证据，这可能有益于未来的预防策略和决策制定。
