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短期室外空气污染对接受经皮冠状动脉介入治疗的冠心病住院患者临床状况及预后的影响

The Impact of Short-Term Outdoor Air Pollution on Clinical Status and Prognosis of Hospitalized Patients with Coronary Artery Disease Treated with Percutaneous Coronary Intervention.

作者信息

Desperak Piotr, Desperak Aneta, Szyguła-Jurkiewicz Bożena, Rozentryt Piotr, Lekston Andrzej, Gąsior Mariusz

机构信息

Third Department of Cardiology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-752 Katowice, Poland.

Department of Toxicology and Health Protection, Faculty of Health Sciences in Bytom, Medical University of Silesia in Katowice, 41-902 Bytom, Poland.

出版信息

J Clin Med. 2022 Jan 18;11(3):484. doi: 10.3390/jcm11030484.

Abstract

BACKGROUND

The aim of this study was to determine the influence of acute exposure to air pollutants on patients' profile, short- and mid-term outcomes of hospitalized patients with coronary artery disease (CAD) treated with coronary angioplasty.

METHODS

Out of 19,582 patients of the TERCET Registry, 7521 patients living in the Upper Silesia and Zaglebie Metropolis were included. The study population was divided into two groups according to the diagnosis of chronic (CCS) or acute coronary syndromes (ACS). Data on 24-h average concentrations of particulate matter with aerodynamic diameter <10 μm (PM10), sulfur dioxide (SO), nitrogen monoxide (NO), nitrogen dioxide (NO), and ozone (O) were obtained from eight environmental monitoring stations.

RESULTS

No significant association between pollutants' concentration with baseline characteristic and in-hospital outcomes was observed. In the ACS group at 30 days, exceeding the 3rd quartile of PM10 was associated with almost 2-fold increased risk of adverse events and more than 3-fold increased risk of death. Exceeding the 3rd quartile of SO was connected with more than 8-fold increased risk of death at 30 days. In the CCS group, exceeding the 3rd quartile of SO was linked to almost 2,5-fold increased risk of 12-month death.

CONCLUSIONS

The acute increase in air pollutants' concentrations affect short- and mid-term prognosis in patients with CAD.

摘要

背景

本研究旨在确定急性暴露于空气污染物对接受冠状动脉成形术治疗的冠心病(CAD)住院患者的病情、短期和中期预后的影响。

方法

在TERCET注册中心的19582例患者中,纳入了居住在上西里西亚和扎格莱比大都会的7521例患者。根据慢性冠状动脉综合征(CCS)或急性冠状动脉综合征(ACS)的诊断,将研究人群分为两组。从八个环境监测站获取了空气动力学直径<10μm的颗粒物(PM10)、二氧化硫(SO)、一氧化氮(NO)、二氧化氮(NO)和臭氧(O)的24小时平均浓度数据。

结果

未观察到污染物浓度与基线特征及住院结局之间存在显著关联。在ACS组中,30天时PM10超过第3四分位数与不良事件风险增加近2倍和死亡风险增加3倍以上相关。SO超过第3四分位数与30天时死亡风险增加8倍以上相关。在CCS组中,SO超过第3四分位数与12个月死亡风险增加近2.5倍相关。

结论

空气污染物浓度的急性升高会影响CAD患者的短期和中期预后。

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