HEOA Group, West China School of Public Health and West China Fourth Hospital, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, Sichuan 610041, China; Institute for Healthy Cities and West China Research Center for Rural Health Development, Sichuan University, No. 16, Section 3, Ren Min Nan Road, Chengdu, Sichuan 610041, China.
Department of Epidemiology, School of Public Health, Sun Yat-sen University, No. 74, Zhongshan 2nd road, Yuexiu District, Guangzhou, Guangdong 510080, China.
Ecotoxicol Environ Saf. 2024 Oct 1;284:116898. doi: 10.1016/j.ecoenv.2024.116898. Epub 2024 Aug 23.
Recent studies have linked the cardiovascular events with the exposure to ambient fine particulate matter (PM); however, the impact of PM chemical components on acute myocardial infarction (AMI) case fatality remains poorly understood. To address this gap, we included 178,340 hospitalised patients with AMI utilising the inpatient discharge database from Sichuan, Shanxi, Guangxi, and Guangdong, China spanning 2014-2019. We evaluated exposure to PM and its components (black carbon (BC), organic matter (OM), sulphate (SO), nitrate (NO), and ammonium (NH)) using bilinear interpolation based on the patient's residential address. We used mixed-effects logistic regression models to investigate the associations of PM and its five components with in-hospital AMI case fatality. Per interquartile range (IQR) increment in short-term exposure (7-day average) to overall PM (odds ratio (OR): 1.086, 95 % confidence interval (CI): 1.045-1.128), SO(1.063, 1.024-1.104), BC (1.055, 1.023-1.089), OM (1.052, 1.019-1.086, and NO (1.045, 1.003-1.089) were significantly associated with high risk of in-hospital AMI case fatality. The ORs per IQR increment in long-term exposure (annual average) were 1.323 (95 % CI: 1.255-1.394) for PM, followed by BC (1.271, 1.210-1.335), OM (1.243, 1.188-1.300), SO (1.212, 1.157-1.270), NO (1.116, 1.075-1.159), and NH (1.068, 1.031-1.106). Our study suggests that PM chemical components might be important risk factors for in-hospital AMI case fatality, highlighting the importance of targeted reduction of PM emissions, particularly BC, OM, and SO.
最近的研究将心血管事件与暴露于环境细颗粒物（PM）联系起来；然而，PM 化学组成部分对急性心肌梗死（AMI）病死率的影响仍知之甚少。为了解决这一差距，我们利用中国四川、山西、广西和广东的住院患者出院数据库，纳入了 178340 名 AMI 住院患者，该数据库涵盖了 2014-2019 年的数据。我们利用基于患者居住地址的双线性插值法，评估了 PM 及其成分（黑碳（BC）、有机物（OM）、硫酸盐（SO）、硝酸盐（NO）和铵（NH））的暴露情况。我们使用混合效应逻辑回归模型来研究 PM 及其五个成分与住院期间 AMI 病死率之间的关联。短期（7 天平均）暴露于整体 PM（比值比（OR）：1.086，95%置信区间（CI）：1.045-1.128）、SO（1.063，1.024-1.104）、BC（1.055，1.023-1.089）、OM（1.052，1.019-1.086）和 NO（1.045，1.003-1.089）的每四分位距（IQR）增加与住院期间 AMI 病死率升高显著相关。长期（年平均）暴露的 IQR 每增加一个单位，PM 的比值比（OR）为 1.323（95%CI：1.255-1.394），其次是 BC（1.271，1.210-1.335）、OM（1.243，1.188-1.300）、SO（1.212，1.157-1.270）、NO（1.116，1.075-1.159）和 NH（1.068，1.031-1.106）。我们的研究表明，PM 化学组成部分可能是住院期间 AMI 病死率的重要危险因素，这突出了有针对性地减少 PM 排放，特别是 BC、OM 和 SO 的重要性。
