Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden.
Atherosclerosis. 2024 Oct;397:117576. doi: 10.1016/j.atherosclerosis.2024.117576. Epub 2024 May 8.
Despite firm evidence for an association between long-term ambient air pollution exposure and cardiovascular morbidity and mortality, results from epidemiological studies on the association between air pollution exposure and atherosclerosis have not been consistent. We investigated associations between long-term low-level air pollution exposure and coronary atherosclerosis.
We performed a cross-sectional analysis in the large Swedish CArdioPulmonary bioImaging Study (SCAPIS, n = 30 154), a random general population sample. Concentrations of total and locally emitted particulate matter <2.5 μm (PM), <10 μm (PM), and nitrogen oxides (NO) at the residential address were modelled using high-resolution dispersion models. We estimated associations between air pollution exposures and segment involvement score (SIS), coronary artery calcification score (CACS), number of non-calcified plaques (NCP), and number of significant stenoses, using ordinal regression models extensively adjusted for potential confounders.
Median 10-year average PM exposure was 6.2 μg/m (range 3.5-13.4 μg/m). 51 % of participants were women and 51 % were never-smokers. None of the assessed pollutants were associated with a higher SIS or CACS. Exposure to PM was associated with NCP (adjusted OR 1.34, 95 % CI 1.13, 1.58, per 2.05 μg/m). Associations with significant stenoses were inconsistent.
In this large, middle-aged general population sample with low exposure levels, air pollution was not associated with measures of total burden of coronary atherosclerosis. However, PM appeared to be associated with a higher prevalence of non-calcified plaques. The results suggest that increased risk of early-stage atherosclerosis or rupture, but not increased total atherosclerotic burden, may be a pathway for long-term air pollution effects on cardiovascular disease.
尽管有确凿的证据表明长期暴露于环境空气中的污染物与心血管发病率和死亡率之间存在关联，但流行病学研究关于空气污染暴露与动脉粥样硬化之间的关联结果并不一致。我们研究了长期低水平空气污染暴露与冠状动脉粥样硬化之间的关系。
我们在大型瑞典心肺生物成像研究（SCAPIS，n=30154）中进行了一项横断面分析，该研究是一项随机的一般人群样本。使用高分辨率弥散模型对居住地址处的总细颗粒物和局地排放细颗粒物（PM）<2.5μm（PM）、<10μm（PM）和氮氧化物（NO）浓度进行建模。我们使用有序回归模型广泛调整潜在混杂因素后，估计了空气污染暴露与节段受累评分（SIS）、冠状动脉钙化评分（CACS）、非钙化斑块数量（NCP）和显著狭窄数量之间的关联。
中位 10 年平均 PM 暴露量为 6.2μg/m（范围 3.5-13.4μg/m）。51%的参与者为女性，51%为从不吸烟者。评估的污染物均与 SIS 或 CACS 升高无关。PM 暴露与 NCP 相关（调整后的 OR 1.34，95%CI 1.13，1.58，每增加 2.05μg/m）。与显著狭窄相关的结果不一致。
在这项大型的中年一般人群样本中，暴露水平较低，空气污染与冠状动脉粥样硬化总负担的测量指标无关。然而，PM 似乎与非钙化斑块的发生率升高有关。结果表明，长期空气污染对心血管疾病的影响可能是通过早期动脉粥样硬化或破裂风险增加而不是总动脉粥样硬化负担增加的途径。
