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Zheng S, Jiang L, Qiu L. The effects of fine particulate matter on the blood-testis barrier and its potential mechanisms. REVIEWS ON ENVIRONMENTAL HEALTH 2024; 39:233-249. [PMID: 36863426 DOI: 10.1515/reveh-2022-0204] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 11/13/2022] [Indexed: 02/17/2024]
Abstract
With the rapid expansion of industrial scale, an increasing number of fine particulate matter (PM2.5) has bringing health concerns. Although exposure to PM2.5 has been clearly associated with male reproductive toxicity, the exact mechanisms are still unclear. Recent studies demonstrated that exposure to PM2.5 can disturb spermatogenesis through destroying the blood-testis barrier (BTB), consisting of different junction types, containing tight junctions (TJs), gap junctions (GJs), ectoplasmic specialization (ES) and desmosomes. The BTB is one of the tightest blood-tissue barriers among mammals, which isolating germ cells from hazardous substances and immune cell infiltration during spermatogenesis. Therefore, once the BTB is destroyed, hazardous substances and immune cells will enter seminiferous tubule and cause adversely reproductive effects. In addition, PM2.5 also has shown to cause cells and tissues injury via inducing autophagy, inflammation, sex hormones disorder, and oxidative stress. However, the exact mechanisms of the disruption of the BTB, induced by PM2.5, are still unclear. It is suggested that more research is required to identify the potential mechanisms. In this review, we aim to understand the adverse effects on the BTB after exposure to PM2.5 and explore its potential mechanisms, which provides novel insight into accounting for PM2.5-induced BTB injury.
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Affiliation(s)
- Shaokai Zheng
- School of Public Health, Nantong University, Nantong, P. R. China
| | - Lianlian Jiang
- School of Public Health, Nantong University, Nantong, P. R. China
| | - Lianglin Qiu
- School of Public Health, Nantong University, Nantong, P. R. China
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2
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Bhonsale A, Zhu J, Thoma F, Koscumb S, Kancharla K, Voigt A, Magnani J, Estes N, Saba S, Marroquin O, Mulukutla S, Jain S. Mortality, Hospitalization, and Cardiac Interventions in Patients With Atrial Fibrillation Aged <65 Years. Circ Arrhythm Electrophysiol 2024; 17:e012143. [PMID: 38646831 PMCID: PMC11111318 DOI: 10.1161/circep.123.012143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 02/12/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND The risk factor (RF) burden, clinical course, and long-term outcome among patients with atrial fibrillation (AF) aged <65 years is unclear. METHODS Adult (n=67 221; mean age, 72.4±12.3 years; and 45% women) patients with AF evaluated at the University of Pittsburgh Medical Center between January 2010 and December 2019 were studied. Hospital system-wide electronic health records and administrative data were utilized to ascertain RFs, comorbidities, and subsequent hospitalization and cardiac interventions. The association of AF with all-cause mortality among those aged <65 years was analyzed using an internal contemporary cohort of patients without AF (n=918 073). RESULTS Nearly one-quarter (n=17 335) of the cohort was aged <65 years (32% women) with considerable cardiovascular RFs (current smoker, 16%; mean body mass index, 33.0±8.3; hypertension, 55%; diabetes, 21%; heart failure, 20%; coronary artery disease, 19%; and prior ischemic stroke, 6%) and comorbidity burden (chronic obstructive pulmonary disease, 11%; obstructive sleep apnea, 18%; and chronic kidney disease, 1.3%). Over mean follow-up of >5 years, 2084 (6.7%, <50 years; 13%, 50-65 years) patients died. The proportion of patients with >1 hospitalization for myocardial infarction, heart failure, and stroke was 1.3%, 4.8%, and 1.1% for those aged <50 years and 2.2%, 7.4%, and 1.1% for the 50- to 65-year subgroup, respectively. Multiple cardiac and noncardiac RFs were associated with increased mortality in younger patients with AF with heart failure and hypertension demonstrating significant age-related interaction (P=0.007 and P=0.013, respectively). Patients with AF aged <65 years experienced significantly worse survival compared with comorbidity-adjusted patients without AF (men aged <50 years and hazard ratio, 1.5 [95% CI, 1.24-1.79]; 50-65 years and hazard ratio, 1.3 [95% CI, 1.26-1.43]; women aged <50 years and hazard ratio, 2.4 [95% CI, 1.82-3.16]; 50-65 years and hazard ratio, 1.7 [95% CI, 1.6-1.92]). CONCLUSIONS Patients with AF aged <65 years have significant comorbidity burden and considerable long-term mortality. They are also at a significantly increased risk of hospitalization for heart failure, stroke, and myocardial infarction. These patients warrant an aggressive focus on RF and comorbidity evaluation and management.
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Affiliation(s)
- Aditya Bhonsale
- Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA
| | - Jianhui Zhu
- Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA
| | - Floyd Thoma
- Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA
| | - Steve Koscumb
- Clinical Analytics (S.K., O.M.), University of Pittsburgh Medical Center, PA
| | - Krishna Kancharla
- Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA
| | - Andrew Voigt
- Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA
| | - Jared Magnani
- Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA
| | - N.A. Estes
- Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA
| | - Samir Saba
- Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA
- Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA
| | - Oscar Marroquin
- Clinical Analytics (S.K., O.M.), University of Pittsburgh Medical Center, PA
| | - Suresh Mulukutla
- Department of Cardiology (J.Z., F.T., J.M., S.S., S.M.), University of Pittsburgh Medical Center, PA
| | - Sandeep Jain
- Division of Cardiac Electrophysiology (A.B., K.K., A.V., N.A.E., S.S., S.J.), University of Pittsburgh Medical Center, PA
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3
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Wass SY, Hahad O, Asad Z, Li S, Chung MK, Benjamin EJ, Nasir K, Rajagopalan S, Al-Kindi SG. Environmental Exposome and Atrial Fibrillation: Emerging Evidence and Future Directions. Circ Res 2024; 134:1029-1045. [PMID: 38603473 PMCID: PMC11060886 DOI: 10.1161/circresaha.123.323477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
There has been increased awareness of the linkage between environmental exposures and cardiovascular health and disease. Atrial fibrillation is the most common sustained cardiac arrhythmia, affecting millions of people worldwide and contributing to substantial morbidity and mortality. Although numerous studies have explored the role of genetic and lifestyle factors in the development and progression of atrial fibrillation, the potential impact of environmental determinants on this prevalent condition has received comparatively less attention. This review aims to provide a comprehensive overview of the current evidence on environmental determinants of atrial fibrillation, encompassing factors such as air pollution, temperature, humidity, and other meteorologic conditions, noise pollution, greenspace, and the social environment. We discuss the existing evidence from epidemiological and mechanistic studies, critically evaluating the strengths and limitations of these investigations and the potential underlying biological mechanisms through which environmental exposures may affect atrial fibrillation risk. Furthermore, we address the potential implications of these findings for public health and clinical practice and identify knowledge gaps and future research directions in this emerging field.
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Affiliation(s)
- Sojin Youn Wass
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (M.K.C., S.Y.W.)
| | - Omar Hahad
- Department of Cardiology, University Medical Center of the Johannes Gutenberg University Mainz, Germany (O.H.)
| | - Zain Asad
- Division of Cardiovascular Medicine, University of Oklahoma Medical Center, Oklahoma City (Z.A.)
| | - Shuo Li
- Biomedical Engineering, Case Western Reserve University, Cleveland, OH (S.L.)
| | - Mina K Chung
- Heart, Vascular and Thoracic Institute, Cleveland Clinic, OH (M.K.C., S.Y.W.)
| | - Emelia J Benjamin
- Section of Cardiovascular Medicine, Department of Medicine, Boston Medical Center, Boston University Chobanian and Avedisian School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (E.J.B.)
| | - Khurram Nasir
- Cardiovascular Prevention and Wellness, DeBakey Heart and Vascular Center, Houston Methodist, TX (K.N., S.G.A.-K.)
| | - Sanjay Rajagopalan
- Harrington Heart and Vascular Institute, University Hospitals, Cleveland, OH (S.R.)
- Case Western Reserve University School of Medicine, Cleveland, OH (S.R.)
| | - Sadeer G Al-Kindi
- Cardiovascular Prevention and Wellness, DeBakey Heart and Vascular Center, Houston Methodist, TX (K.N., S.G.A.-K.)
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4
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Krittanawong C, Qadeer YK, Hayes RB, Wang Z, Thurston GD, Virani S, Lavie CJ. PM 2.5 and cardiovascular diseases: State-of-the-Art review. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 19:200217. [PMID: 37869561 PMCID: PMC10585625 DOI: 10.1016/j.ijcrp.2023.200217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 09/09/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023]
Abstract
Air pollution, especially exposure to particulate matter 2.5 (PM2.5), has been associated with an increase in morbidity and mortality around the world. Specifically, it seems that PM2.5 promotes the development of cardiovascular risk factors such as hypertension and atherosclerosis, while being associated with an increased risk of cardiovascular diseases, including myocardial infarction (MI), stroke, heart failure, and arrhythmias. In this review, we seek to elucidate the pathophysiological mechanisms by which exposure to PM2.5 can result in adverse cardiovascular outcomes, in addition to understanding the link between exposure to PM2.5 and cardiovascular events. It is hypothesized that PM2.5 functions via 3 mechanisms: increased oxidative stress, activation of the inflammatory pathway of the immune system, and stimulation of the autonomic nervous system which ultimately promote endothelial dysfunction, atherosclerosis, and systemic inflammation that can thus lead to cardiovascular events. It is important to note that the various cardiovascular associations of PM2.5 differ regarding the duration of exposure (short vs long) to PM2.5, the source of PM2.5, and regulations regarding air pollution in the area where PM2.5 is prominent. Current strategies to reduce PM2.5 exposure include personal strategies such as avoiding high PM2.5 areas such as highways or wearing masks outdoors, to governmental policies restricting the amount of PM2.5 produced by organizations. This review, by highlighting the significant impact between PM2.5 exposure and cardiovascular health will hopefully bring awareness and produce significant change regarding dealing with PM2.5 levels worldwide.
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Affiliation(s)
| | | | - Richard B. Hayes
- Division of Epidemiology, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Zhen Wang
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
- Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - George D. Thurston
- Department of Environmental Medicine, New York University School of Medicine, Tuxedo, New York, USA
| | - Salim Virani
- Section of Cardiology, Baylor College of Medicine, Houston, TX, USA
- The Aga Khan University, Karachi, Pakistan
| | - Carl J. Lavie
- John Ochsner Heart and Vascular Institute, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, LA, USA
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5
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Bongaerts E, Mamia K, Rooda I, Björvang RD, Papaikonomou K, Gidlöf SB, Olofsson JI, Ameloot M, Alfaro-Moreno E, Nawrot TS, Damdimopoulou P. Ambient black carbon particles in human ovarian tissue and follicular fluid. ENVIRONMENT INTERNATIONAL 2023; 179:108141. [PMID: 37603992 DOI: 10.1016/j.envint.2023.108141] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 07/10/2023] [Accepted: 08/09/2023] [Indexed: 08/23/2023]
Abstract
Evidence indicates a link between exposure to ambient air pollution and decreased female fertility. The ability of air pollution particles to reach human ovarian tissue and follicles containing the oocytes in various maturation stages has not been studied before. Particulate translocation might be an essential step in explaining reproductive toxicity and assessing associated risks. Here, we analysed the presence of ambient black carbon particles in (i) follicular fluid samples collected during ovum pick-up from 20 women who underwent assisted reproductive technology treatment and (ii) adult human ovarian tissue from 5 individuals. Follicular fluid and ovarian tissue samples were screened for the presence of black carbon particles from ambient air pollution using white light generation by carbonaceous particles under femtosecond pulsed laser illumination. We detected black carbon particles in all follicular fluid (n = 20) and ovarian tissue (n = 5) samples. Black carbon particles from ambient air pollution can reach the ovaries and follicular fluid, directly exposing the ovarian reserve and maturing oocytes. Considering the known link between air pollution and decreased fertility, the impact of such exposure on oocyte quality, ovarian ageing and fertility needs to be clarified urgently.
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Affiliation(s)
- Eva Bongaerts
- Centre for Environmental Sciences, Hasselt University, 3590 Hasselt, Belgium
| | - Katariina Mamia
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Ilmatar Rooda
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden
| | - Richelle D Björvang
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Uppsala University, 75185 Uppsala, Sweden
| | - Kiriaki Papaikonomou
- Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Sebastian B Gidlöf
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden; Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Jan I Olofsson
- Department of Women's and Children's Health, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Marcel Ameloot
- Biomedical Research Institute, Hasselt University, 3590 Hasselt, Belgium
| | - Ernesto Alfaro-Moreno
- Nanosafety Group, International Iberian Nanotechnology Laboratory, 4715-330 Braga, Portugal
| | - Tim S Nawrot
- Centre for Environmental Sciences, Hasselt University, 3590 Hasselt, Belgium; Department of Public Health and Primary Care, KU Leuven, 3000 Leuven, Belgium
| | - Pauliina Damdimopoulou
- Division of Obstetrics and Gynaecology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, 141 86 Huddinge, Sweden; Department of Gynaecology and Reproductive Medicine, Karolinska University Hospital, 141 86 Huddinge, Sweden.
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6
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Mandaglio-Collados D, López-Gálvez R, Ruiz-Alcaraz AJ, López-García C, Roldán V, Lip GYH, Marín F, Rivera-Caravaca JM. Impact of particulate matter on the incidence of atrial fibrillation and the risk of adverse clinical outcomes: A review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163352. [PMID: 37023806 DOI: 10.1016/j.scitotenv.2023.163352] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 03/23/2023] [Accepted: 04/03/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Atrial fibrillation (AF) is common and increases the risk of stroke and mortality. Previous studies have suggested that air pollution is an important risk factor for new-onset AF. Herein, we review the evidence regarding: 1) the association between exposure to particulate matter (PM) and new-onset AF, and 2) the risk of worse clinical outcomes in patients with pre-existent AF and their relation to PM exposure. METHODS A selection of studies between 2000 and 2023 linking PM exposure and AF was performed through searches in PubMed, Scopus, Web of Science, and Google Scholar. RESULTS 17 studies from different geographical areas demonstrated that exposure to PM was associated with an increased risk of new-onset AF, although the results were heterogeneous regarding the temporal pattern (short- or long-term) ultimately related to AF. Most of the studies concluded that the risk of new-onset AF increased between 2 %-18 % per 10 μg/m3 increment in PM2.5 or PM10 concentrations, whereas the incidence (percentage of change of incidence) increased between 0.29 %-2.95 % per 10 μg/m3 increment in PM2.5 or PM10. Evidence about the association between PM and adverse events in patients with pre-existent AF was scarce but 4 studies showed a higher risk of mortality and stroke (between 8 %-64 % in terms of hazard ratio) in patients with pre-existent AF when PM exposure was higher. CONCLUSIONS Exposure to PM (both PM2.5 and PM10) is a risk factor for AF, and a risk factor for mortality and stroke in patients who already suffer from AF. Since the relationship between PM and AF is independent of the region of the world, PM should be considered as a global risk factor for both AF and worse clinical outcomes in AF patients. Specific measures to prevent air pollution exposure need to be adopted.
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Affiliation(s)
- Darío Mandaglio-Collados
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Raquel López-Gálvez
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Antonio José Ruiz-Alcaraz
- Department of Biochemistry and Molecular Biology and Immunology, Faculty of Medicine, University of Murcia, Murcia, Spain
| | - Cecilia López-García
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain
| | - Vanessa Roldán
- Department of Hematology and Clinical Oncology, Hospital General Universitario Morales Meseguer, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), Murcia, Spain
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Francisco Marín
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain.
| | - José Miguel Rivera-Caravaca
- Department of Cardiology, Hospital Clínico Universitario Virgen de la Arrixaca, University of Murcia, Instituto Murciano de Investigación Biosanitaria (IMIB-Arrixaca), CIBERCV, Murcia, Spain; Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom; Faculty of Nursing, University of Murcia, Murcia, Spain
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7
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Huang JB, Huang KC, Hsieh TM, Tsai CM, Hsiao HY, Cheng CY, Cheng FJ. Association between Air Pollution and Short-Term Outcome of ST-Segment Elevation Myocardial Infarction in a Tropical City, Kaohsiung, Taiwan. TOXICS 2023; 11:541. [PMID: 37368641 DOI: 10.3390/toxics11060541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/15/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023]
Abstract
ST-segment elevation myocardial infarction (STEMI), one of the primary factors leading to global mortality, has been shown through epidemiological studies to have a relationship with short-term exposure to air pollutants; however, the association between air pollutants and the outcome of STEMI has not been well studied. The aim of this study was to estimate the impact of air pollutants on the outcomes of STEMI. Data on particulate matter <2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) at each of the 11 air monitoring stations in Kaohsiung City were collected between 1 January 2012 and 31 December 2017. Medical records of non-trauma patients aged > 20 years who had presented to the Emergency Department (ED) with a principal diagnosis of STEMI were extracted. The primary outcome measure was in-hospital mortality. After adjusting for potential confounders and meteorological variables, we found that an increase in the interquartile range (IQR) in NO2 was associated with an elevated risk of in-hospital mortality in patients with STEMI. Moreover, there was an observed higher risk of in-hospital mortality associated with an increase in the IQR of NO2 during the warm season, specifically in lag 3 (3 days prior to the onset, OR = 3.266; 95%CI: 1.203-8.864, p = 0.02). Conversely, an IQR increase in PM10 was associated with an increased risk of in-hospital mortality in patients with STEMI in lag 3 (OR = 2.792; 95%CI: 1.115-6.993, p = 0.028) during the cold season. Our study suggests that exposure to NO2 (during the warm season) and PM10 (during the cold season) may contribute to a higher risk of poor prognosis in patients with STEMI.
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Affiliation(s)
- Jyun-Bin Huang
- Department of Emergency Medicine, Kaohsiung Municipal Feng Shan Hospital-Under The Management of Chang Gung Medical Foundation, Fengshan District, Kaohsiung 830, Taiwan
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Kuo-Chen Huang
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Ting-Min Hsieh
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Division of Trauma, Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Chih-Min Tsai
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Department of Pediatrics, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niao-Sung District, Kaohsiung City 833, Taiwan
| | - Hao-Yi Hsiao
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Chi-Yung Cheng
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
| | - Fu-Jen Cheng
- College of Medicine, Chang Gung University, No. 259, Wenhua 1st Road, Guishan District, Taoyuan City 333, Taiwan
- Department of Emergency Medicine, Kaohsiung Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Kaohsiung 833, Taiwan
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8
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Tran PM, Warren JL, Leifheit EC, Goldstein LB, Lichtman JH. Associations Between Long-Term Air Pollutant Exposure and 30-Day All-Cause Hospital Readmissions in US Patients With Stroke. Stroke 2023; 54:e126-e129. [PMID: 36729388 PMCID: PMC11059199 DOI: 10.1161/strokeaha.122.042265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 02/01/2023] [Indexed: 02/03/2023]
Abstract
BACKGROUND Long-term exposure to air pollutants is associated with increased stroke incidence, morbidity, and mortality; however, research on the association of pollutant exposure with poststroke hospital readmissions is lacking. METHODS We assessed associations between average annual carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), particulate matter 2.5, and sulfur dioxide (SO2) exposure and 30-day all-cause hospital readmission in US fee-for-service Medicare beneficiaries age ≥65 years hospitalized for ischemic stroke in 2014 to 2015. We fit Cox models to assess 30-day readmissions as a function of these pollutants, adjusted for patient and hospital characteristics and ambient temperature. Analyses were then stratified by treating hospital performance on the Centers for Medicare and Medicaid Services risk-standardized 30-day poststroke all-cause readmission measure to determine if the results were independent of performance: low (Centers for Medicare and Medicaid Services rate for hospital <25th percentile of national rate), high (>75th percentile), and intermediate (all others). RESULTS Of 448 148 patients with stroke, 12.5% were readmitted within 30 days. Except for tropospheric NO2 (no national standard), average 2-year CO, O3, particulate matter 2.5, and SO2 values were below national limits. Each one SD increase in average annual CO, NO2, particulate matter 2.5, and SO2 exposure was associated with an adjusted 1.1% (95% CI, 0.4-1.9%), 3.6% (95% CI, 2.9%-4.4%), 1.2% (95% CI, 0.2%-2.3%), and 2.0% (95% CI, 1.1%-3.0%) increased risk of 30-day readmission, respectively, and O3 with a 0.7% (95% CI, 0.0%-1.5%) decrease. Associations between long-term air pollutant exposure and increased readmissions persisted across hospital performance categories. CONCLUSIONS Long-term air pollutant exposure below national limits was associated with increased 30-day readmissions after stroke, regardless of hospital performance category. Whether air quality improvements lead to reductions in poststroke readmissions requires further research.
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Affiliation(s)
| | | | - Erica C. Leifheit
- Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
| | | | - Judith H. Lichtman
- Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
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Wang M, Han Y, Wang CJ, Xue T, Gu HQ, Yang KX, Liu HY, Cao M, Meng X, Jiang Y, Yang X, Zhang J, Xiong YY, Zhao XQ, Liu LP, Wang YL, Guan TJ, Li ZX, Wang YJ. Short-term effect of PM2.5 on stroke in susceptible populations: A case-crossover study. Int J Stroke 2023; 18:312-321. [PMID: 35722790 DOI: 10.1177/17474930221110024] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Fine particulate matter (PM2.5) is a risk factor for stroke, and patients with pre-existing diseases appear to be particularly susceptible. We conducted a case-crossover study to examine the association between short-term exposure to fine particulate matter (PM2.5) and hospital admission for stroke in individuals with atrial fibrillation (AF), hypertension, diabetes, or hyperlipidemia. METHODS Patients diagnosed with acute ischemic stroke (AIS) were recruited from 2015 to 2017 in Chinese Stroke Center Alliances. We estimated daily PM2.5 average exposures with a spatial resolution of 0.1° using a data assimilation approach combining satellite measurements, air model simulations, and monitoring values. Conditional logistic regression was used to assess PM2.5-related stroke risk in patients with pre-existing medical co-morbidities. RESULTS A total of 155,616 patients diagnosed with AIS were admitted. Patients with a history of AF (n = 15,430), hypertension (n = 138,220), diabetes (n = 43,737), or hyperlipidemia (n = 16,855) were assessed separately. A 10 µg/m3 increase in daily PM2.5 was associated with a significant increase in AIS for individuals with AF at lag 4 (odds ratio (OR), 1.008; 95% confidence interval (CI), 1.002-1.014), and with hypertension (OR, 1.008; 95% CI, 1.006-1.010), diabetes (OR, 1.006; 95% CI, 1.003-1.010), and hyperlipidemia (OR, 1.007; 95% CI, 1.001-1.012) at lags 0-7. Elderly (⩾ 65 years old) and female patients with AF had significantly higher associations at lag 5 (OR, 1.009; 95% CI, 1.002-1.015) and lag 5 (OR, 1.010; 95% CI, 1.002-1.018), respectively. CONCLUSION Short-term exposure to PM2.5 is significantly associated with hospital admission for stroke in individuals with pre-existing medical histories, especially in older or female patients with AF. Preventive measures to reduce PM2.5 concentrations are particularly important in individuals with other medical co-morbidities.
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Affiliation(s)
- Meng Wang
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Ying Han
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Chun-Juan Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Tao Xue
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Hong-Qiu Gu
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Kai-Xuan Yang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Heng-Yi Liu
- Institute of Reproductive and Child Health, Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Man Cao
- Department of Health Policy and Management, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xia Meng
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yong Jiang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xin Yang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Jing Zhang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China
| | - Yun-Yun Xiong
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xing-Quan Zhao
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Li-Ping Liu
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yi-Long Wang
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tian-Jia Guan
- Department of Health Policy and Management, School of Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zi-Xiao Li
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,National Center for Healthcare Quality Management in Neurological Diseases, Beijing, China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China.,Chinese Institute for Brain Research, Beijing, China
| | - Yong-Jun Wang
- Vascular Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.,Research Unit of Artificial Intelligence in Cerebrovascular Disease, Chinese Academy of Medical Sciences, Beijing, China.,Chinese Institute for Brain Research, Beijing, China.,Center for Excellence in Brain Science and Intelligence Technology, Chinese Academy of Sciences, Shanghai, China.,Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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10
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Benjamin EJ, Thomas KL, Go AS, Desvigne-Nickens P, Albert CM, Alonso A, Chamberlain AM, Essien UR, Hernandez I, Hills MT, Kershaw KN, Levy PD, Magnani JW, Matlock DD, O'Brien EC, Rodriguez CJ, Russo AM, Soliman EZ, Cooper LS, Al-Khatib SM. Transforming Atrial Fibrillation Research to Integrate Social Determinants of Health: A National Heart, Lung, and Blood Institute Workshop Report. JAMA Cardiol 2023; 8:182-191. [PMID: 36478155 PMCID: PMC10993288 DOI: 10.1001/jamacardio.2022.4091] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Only modest attention has been paid to the contributions of social determinants of health to atrial fibrillation (AF) risk factors, diagnosis, symptoms, management, and outcomes. The diagnosis of AF provides unique challenges exacerbated by the arrhythmia's often paroxysmal nature and individuals' disparate access to health care and technologies that facilitate detection. Social determinants of health affect access to care and management decisions for AF, increasing the likelihood of adverse outcomes among individuals who experience systemic disadvantages. Developing effective approaches to address modifiable social determinants of health requires research to eliminate the substantive inequities in health care delivery and outcomes in AF. Observations The National Heart, Lung, and Blood Institute convened an expert panel to identify major knowledge gaps and research opportunities in the field of social determinants of AF. The workshop addressed the following social determinants: (1) socioeconomic status and access to care; (2) health literacy; (3) race, ethnicity, and racism; (4) sex and gender; (5) shared decision-making in systemically disadvantaged populations; and (6) place, including rurality, neighborhood, and community. Many individuals with AF have multiple adverse social determinants, which may cluster in the individual and in systemically disadvantaged places (eg, rural locations, urban neighborhoods). Cumulative disadvantages may accumulate over the life course and contribute to inequities in the diagnosis, management, and outcomes in AF. Conclusions and Relevance Workshop participants identified multiple critical research questions and approaches to catalyze social determinants of health research that address the distinctive aspects of AF. The long-term aspiration of this work is to eradicate the substantive inequities in AF diagnosis, management, and outcomes across populations.
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Affiliation(s)
- Emelia J Benjamin
- Cardiovascular Medicine, Department of Medicine, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Kevin L Thomas
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
| | - Alan S Go
- Division of Research, Kaiser Permanente Northern California, Oakland
- Department of Epidemiology and Biostatistics, University of California, San Francisco
- Department of Medicine, Stanford University, Stanford, California
- Department of Medicine, University of California, San Francisco
| | - Patrice Desvigne-Nickens
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Christine M Albert
- Department of Cardiology, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Alanna M Chamberlain
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota
| | - Utibe R Essien
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Inmaculada Hernandez
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of California, San Diego
| | | | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Phillip D Levy
- Department of Emergency Medicine and Integrated Biosciences Center, Wayne State University, Detroit, Michigan
| | - Jared W Magnani
- Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Daniel D Matlock
- Division of Geriatrics, University of Colorado, Anschutz Medical Campus, Aurora
- VA Eastern Colorado Geriatric Research Education and Clinical Center, Denver
| | - Emily C O'Brien
- Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Carlos J Rodriguez
- Division of Cardiovascular Medicine and Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, New York
| | - Andrea M Russo
- Cooper Medical School of Rowan University, Camden, New Jersey
| | - Elsayed Z Soliman
- Section on Cardiovascular Medicine, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lawton S Cooper
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
| | - Sana M Al-Khatib
- Division of Cardiology, Duke Clinical Research Institute, Duke University Medical Center, Durham, North Carolina
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11
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Jacobsen AP, Khiew YC, Duffy E, O'Connell J, Brown E, Auwaerter PG, Blumenthal RS, Schwartz BS, McEvoy JW. Climate change and the prevention of cardiovascular disease. Am J Prev Cardiol 2022; 12:100391. [PMID: 36164332 PMCID: PMC9508346 DOI: 10.1016/j.ajpc.2022.100391] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/27/2022] [Accepted: 09/10/2022] [Indexed: 11/26/2022] Open
Abstract
Climate change is a worsening global crisis that will continue negatively impacting population health and well-being unless adaptation and mitigation interventions are rapidly implemented. Climate change-related cardiovascular disease is mediated by air pollution, increased ambient temperatures, vector-borne disease and mental health disorders. Climate change-related cardiovascular disease can be modulated by climate change adaptation; however, this process could result in significant health inequity because persons and populations of lower socioeconomic status have fewer adaptation options. Clear scientific evidence for climate change and its impact on human health have not yet resulted in the national and international impetus and policies necessary to slow climate change. As respected members of society who regularly communicate scientific evidence to patients, clinicians are well-positioned to advocate on the importance of addressing climate change. This narrative review summarizes the links between climate change and cardiovascular health, proposes actionable items clinicians and other healthcare providers can execute both in their personal life and as an advocate of climate policies, and encourages communication of the health impacts of climate change when counseling patients. Our aim is to inspire the reader to invest more time in communicating the most crucial public health issue of the 21st century to their patients.
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Affiliation(s)
- Alan P. Jacobsen
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yii Chun Khiew
- Division of Gastroenterology, Department of Gastroenterology, MedStar Georgetown University Hospital, Washington, DC, United States
| | - Eamon Duffy
- Division of Cardiology, Department of Medicine, Columbia University Irving Medical Center, New York, NY, United States
| | - James O'Connell
- Department of Public Health, Health Service Executive West, Galway, Ireland
| | - Evans Brown
- Department of Medicine, Division of Hospital Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Paul G. Auwaerter
- Sherrilyn and Ken Fisher Center for Environmental Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Roger S. Blumenthal
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Brian S. Schwartz
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - John William McEvoy
- Ciccarone Center for the Prevention of Cardiovascular Disease, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- National Institute for Prevention and Cardiovascular Health, National University of Ireland Galway, Galway, Ireland
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12
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Kuźma Ł, Roszkowska S, Święczkowski M, Dąbrowski EJ, Kurasz A, Wańha W, Bachórzewska-Gajewska H, Dobrzycki S. Exposure to air pollution and its effect on ischemic strokes (EP-PARTICLES study). Sci Rep 2022; 12:17150. [PMID: 36229478 PMCID: PMC9563068 DOI: 10.1038/s41598-022-21585-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 09/29/2022] [Indexed: 01/04/2023] Open
Abstract
It is well known that exceeded levels of particulate matter in the air and other air pollutants harmfully affect the cardiovascular system. Empirical analyses of the effects of these factors on stroke incidence and mortality are still limited. The main objective of our analyses was to determine the association between short-term exposure to air pollutants and stroke incidence in non-industrial areas, more specifically in north-eastern Poland. To achieve this aim, we used data from the National Health Fund on patients hospitalized for stroke between 2011 and 2020 in the largest city of the region described as the Green Lungs of Poland. The pollution levels and atmospheric conditions data were obtained from the Provincial Inspectorate for Environmental Protection and the Institute of Meteorology and Water Management. Using daily data on hospitalizations, atmospheric conditions, and pollution, as well as ordered logistic regression models the hypotheses on the impact of weather and air pollution conditions on ischemic strokes were tested. The study group included 4838 patients, 45.6% of whom were male; the average patient age was approximately 74 years. The average concentrations of PM2.5 were 19.09 µg/m3, PM10 26.66 µg/m3 and CO 0.35 µg/m3. Analyses showed that an increase in PM2.5 and PM10 concentrations by 10 µg/m3 was associated with an increase in the incidence of stroke on the day of exposure (OR = 1.075, 95% CI 0.999-1.157, P = 0.053; OR = 1.056, 95% CI 1.004-1.110, P = 0.035) and the effect was even several times greater on the occurrence of a stroke event in general (PM2.5: OR = 1.120, 95% CI 1.013-1.237, P = 0.026; PM10: OR = 1.103, 95% CI 1.028-1.182, P = 0.006). Furthermore, a short-term (up to 3 days) effect of CO on stroke incidence was observed in the study area. An increase of 1 μg/m3 CO was associated with a lower incidence of stroke 2 days after the exposure (OR = 0.976, 95% CI 0.953-0.998, P = 0.037) and a higher incidence 3 days after the exposure (OR = 1.026, 95% CI 1.004-1.049, P = 0.022).
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Affiliation(s)
- Łukasz Kuźma
- grid.48324.390000000122482838Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Sylwia Roszkowska
- grid.10789.370000 0000 9730 2769Faculty of Economics and Sociology, University of Lodz, Łódź, Poland ,grid.12847.380000 0004 1937 1290Faculty of Management, University of Warsaw, Warsaw, Poland
| | - Michał Święczkowski
- grid.48324.390000000122482838Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Emil Julian Dąbrowski
- grid.48324.390000000122482838Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Anna Kurasz
- grid.48324.390000000122482838Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
| | - Wojciech Wańha
- grid.411728.90000 0001 2198 0923Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - Hanna Bachórzewska-Gajewska
- grid.48324.390000000122482838Department of Invasive Cardiology, Department of Clinical Medicine, Medical University of Bialystok, Białystok, Poland
| | - Sławomir Dobrzycki
- grid.48324.390000000122482838Department of Invasive Cardiology, Medical University of Bialystok, Białystok, Poland
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13
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Ambient Air Pollution and Acute Ischemic Stroke—Effect Modification by Atrial Fibrillation. J Clin Med 2022; 11:jcm11185429. [PMID: 36143076 PMCID: PMC9503161 DOI: 10.3390/jcm11185429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/03/2022] [Accepted: 09/12/2022] [Indexed: 11/17/2022] Open
Abstract
Acute ischemic strokes (AIS) are closely linked with air pollution, and there is some evidence that traditional cardiovascular risk factors may alter the relationship between air pollution and strokes. We investigated the effect of atrial fibrillation (AF) on the association of AIS with air pollutants. This was a nationwide, population-based, case-only study that included all AIS treated in public healthcare institutions in Singapore from 2009 to 2018. Using multivariable logistic regression, adjusted for time-varying meteorological effects, we examined how AF modified the association between AIS and air pollutant exposure. A total of 51,673 episodes of AIS were included, with 10,722 (20.7%) having AF. The odds of AIS in patients with AF is higher than those without AF for every 1 µg/m3 increase in O3 concentration (adjusted OR [aOR]: 1.005, 95% CI 1.003–1.007) and every 1 mg/m3 increase in CO concentration (aOR: 1.193, 95% CI 1.050–1.356). However, the odds of AIS in patients with AF is lower than those without AF for every 1 µg/m3 increase in SO2 concentration (aOR: 0.993, 95% CI 0.990–0.997). Higher odds of AIS among AF patients as O3− and CO concentrations increase are also observed in patients aged ≥65 years and non-smokers. The results suggest that AF plays an important role in exacerbating the risk of AIS as the levels of O3 and CO increase.
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14
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Gao L, Qin JX, Shi JQ, Jiang T, Wang F, Xie C, Gao Q, Zhi N, Dong Q, Guan YT. Fine particulate matter exposure aggravates ischemic injury via NLRP3 inflammasome activation and pyroptosis. CNS Neurosci Ther 2022; 28:1045-1058. [PMID: 35403328 PMCID: PMC9160454 DOI: 10.1111/cns.13837] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 10/26/2021] [Accepted: 11/11/2021] [Indexed: 12/12/2022] Open
Abstract
Aims Accumulating evidence has suggested that airborne fine particulate matter (PM2.5) exposure is associated with an increased risk of ischemic stroke. However, the underlying mechanisms have not been fully elucidated. In this study, we aim to investigate the role and mechanisms of NLRP3 inflammasome and pyroptosis in ischemic stroke after PM2.5 exposure. Methods The BV‐2 and HMC‐3 microglial cell lines were established and subjected to oxygen–glucose deprivation and reoxygenation (OGD/R) with or without PM2.5 exposure. We used the CCK‐8 assay to explore the effects of PM2.5 on cell viability of BV‐2 and HMC‐3 cells. Then, the effects of PM2.5 exposure on NLRP3 inflammasome and pyroptosis following OGD/R were detected by western blotting, ELISA, and the confocal immunofluorescence staining. Afterwards, NLRP3 was knocked down to further validate the effects of PM2.5 on cell viability, NLRP3 inflammasome activation, and pyroptosis after OGD/R in HMC‐3 cells. Finally, the intracellular reactive oxygen species (ROS) was measured and the ROS inhibitor N‐acetyl‐L‐cysteine (NAC) was used to investigate whether ROS was required for PM2.5‐induced NLRP3 inflammasome activation and pyroptosis under ischemic conditions. Results We found that PM2.5 exposure decreased the viability of BV‐2 and HMC‐3 cells in a dose‐ and time‐dependent manner under ischemic conditions. Furthermore, PM2.5 exposure aggravated NLRP3 inflammasome activation and pyroptosis after OGD/R, as indicated by an increased expression of NLRP3, ASC, pro‐caspase‐1, Caspase‐1, GSDMD, and GSDMD‐N; increased production of IL‐1β and IL‐18; and enhanced Caspase‐1 activity and SYTOX green uptake. However, shRNA NLRP3 treatment attenuated the effects of PM2.5 on cell viability, NLRP3 inflammasome activation, and pyroptosis. Moreover, we observed that PM2.5 exposure increased the production of intracellular ROS following OGD/R, while inhibiting ROS production with NAC partially attenuated PM2.5‐induced NLRP3 inflammasome activation and pyroptosis under ischemic conditions. Conclusion These results suggested that PM2.5 exposure triggered the activation of NLRP3 inflammasome and pyroptosis under ischemic conditions, which may be mediated by increased ROS production after ischemic stroke. These findings may provide a more enhanced understanding of the interplay between PM2.5 and neuroinflammation and cell death, and reveal a novel mechanism of PM2.5‐mediated toxic effects after ischemic stroke.
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Affiliation(s)
- Li Gao
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie-Xing Qin
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jian-Quan Shi
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Teng Jiang
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Fei Wang
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chong Xie
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Gao
- Department of Neurology, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Nan Zhi
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qing Dong
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang-Tai Guan
- Department of Neurology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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15
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Sîrbu CA, Stefan I, Dumitru R, Mitrica M, Manole AM, Vasile TM, Stefani C, Ranetti AE. Air Pollution and Its Devastating Effects on the Central Nervous System. Healthcare (Basel) 2022; 10:1170. [PMID: 35885697 PMCID: PMC9324939 DOI: 10.3390/healthcare10071170] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/14/2022] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
Air pollution is a real public health problem, it being one of the five most common causes of mortality in developing countries. However, pollution studies have focused on the cardiovascular and pulmonary systems in recent decades. Recently, researchers have moved towards a new direction, tracing a direct link between pollution and stroke. Stroke has many known risk factors such as smoking, a sedentary lifestyle, and hypertension. Pollution is universally widespread, already a matter of public interest, so that, although intuitive, it is difficult to connect the two. The particles found in the air that we breathe, regardless of their origin, can attack the body in different ways, causing inflammation, and triggering a true cascade of phenomena that end up attacking the central nervous system and other organs. This article tries to explain the series of phenomena that determine the harmful effect of particles present in the air, with an increased focus on the central nervous system and especially on strokes. A deeper understanding of these phenomena helps in guiding future studies and finding viable solutions to protect people at risk.
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Affiliation(s)
- Carmen Adella Sîrbu
- Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania; (C.A.S.); (R.D.)
| | - Ion Stefan
- Department of Infectious Diseases, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania
- Department of Medico-Surgical and Prophylactic Disciplines, Titu Maiorescu University, 031593 Bucharest, Romania
| | - Rodica Dumitru
- Department of Neurology, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania; (C.A.S.); (R.D.)
| | - Marian Mitrica
- Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania;
| | - Aida Mihaela Manole
- Department of Neurology, Clinical Ambulatory, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania;
| | - Titus Mihai Vasile
- Clinical Neurosciences Department, University of Medicine and Pharmacy “Carol Davila” Bucharest, 050474 Bucharest, Romania;
| | - Constantin Stefani
- Department of Family Medicine and Clinical Base, ‘Dr. Carol Davila’ Central Military Emergency University Hospital, 010242 Bucharest, Romania;
- Department No. 5, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania
| | - Aurelian Emil Ranetti
- Department No. 2, University of Medicine and Pharmacy “Carol Davila”, 050474 Bucharest, Romania;
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16
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Schmidt CW. Hemispheres of Influence: Bridging the Disconnect between Environmental Neurotoxicology and Clinical Practice. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:52001. [PMID: 35543742 PMCID: PMC9093734 DOI: 10.1289/ehp9013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 02/23/2021] [Indexed: 06/14/2023]
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17
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Essien UR, McCabe ME, Kershaw KN, Youmans QR, Fine MJ, Yancy CW, Khan SS. Association Between Neighborhood-Level Poverty and Incident Atrial Fibrillation: a Retrospective Cohort Study. J Gen Intern Med 2022; 37:1436-1443. [PMID: 34240286 PMCID: PMC9086074 DOI: 10.1007/s11606-021-06976-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/09/2021] [Indexed: 12/01/2022]
Abstract
BACKGROUND Atrial fibrillation (AF) is a leading cause of cardiovascular morbidity and mortality. While neighborhood-level factors, such as poverty, have been related to prevalence of AF risk factors, the association between neighborhood poverty and incident AF has been limited. OBJECTIVE Using a large cohort from a health system serving the greater Chicago area, we sought to determine the association between neighborhood-level poverty and incident AF. DESIGN Retrospective cohort study. PARTICIPANTS Adults, aged 30 to 80 years, without baseline cardiovascular disease from January 1, 2005, to December 31, 2018. MAIN MEASURES We geocoded and matched residential addresses of all eligible patients to census-level poverty estimates from the American Community Survey. Neighborhood-level poverty (low, intermediate, and high) was defined as the proportion of residents in the census tract living below the federal poverty threshold. We used generalized linear mixed effects models with a logit link function to examine the association between neighborhood poverty and incident AF, adjusting for patient demographic and clinical AF risk factors. KEY RESULTS Among 28,858 in the cohort, patients in the high poverty group were more often non-Hispanic Black or Hispanic and had higher rates of AF risk factors. Over 5 years of follow-up, 971 (3.4%) patients developed incident AF. Of these, 502 (51.7%) were in the low poverty, 327 (33.7%) in the intermediate poverty, and 142 (14.6%) in the high poverty group. The adjusted odds ratio (aOR) of AF was higher for the intermediate poverty compared with that for the low poverty group (aOR 1.23 [95% CI 1.01-1.48]). The point estimate for the aOR of AF incidence was similar, but not statistically significant, for the high poverty compared with the low poverty group (aOR 1.25 [95% CI 0.98-1.59]). CONCLUSION In adults without baseline cardiovascular disease managed in a large, integrated health system, intermediate neighborhood poverty was significantly associated with incident AF. Understanding neighborhood-level drivers of AF disparities will help achieve equitable care.
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Affiliation(s)
- Utibe R Essien
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA. .,Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA.
| | - Megan E McCabe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Quentin R Youmans
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Michael J Fine
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Clyde W Yancy
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sadiya S Khan
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Deng Y, Zhao H, Liu Y, Liu H, Shi J, Zhao C, He M. Association of using biomass fuel for cooking with depression and anxiety symptoms in older Chinese adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 811:152256. [PMID: 34896507 DOI: 10.1016/j.scitotenv.2021.152256] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 11/10/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUNDS Household air pollution exposure is a crucial public concern and have the potential to seriously affect human health. Using biomass fuels for cooking is the main contributor to household air pollution. However, current evidence linked between cooking with biomass fuels and mental health remains limited. OBJECTIVES To explore whether cooking with biomass fuels is associated with depression and anxiety symptoms among older adults in China. METHODS We obtained data from Chinese Longitudinal Healthy Longevity Survey (CLHLS). Depressive and anxiety symptoms were assessed using the 10-item Center for Epidemiologic Studies Depression Scale (CES-D-10) and the 7-item Generalized Anxiety Disorder Scale (GAD-7), respectively. Primary cooking fuel type was self-reported. We used logistic regression and linear regression to evaluate the effects of cooking with biomass fuels on depression and anxiety. RESULTS A total of 13,361 participants aged 65 years and older (mean age, 84.2 ± 11.5 years) were included in the presented study. A positive association was found between cooking with biomass fuels and both depression symptoms (adjusted odds ratio 1.23, 95% CI 1.03 to 1.47) and anxiety symptoms (adjusted odds ratio 1.31, 95% CI 1.02 to 1.68). Biomass fuel users had a higher depression scores (0.33, 95% CI 0.03 to 0.61) and a higher anxiety scores (0.20, 95% CI 0.02 to 0.38) compared to clean fuel users. We found no significant interactions between participant characteristics and biomass fuel use on either depression or anxiety symptoms. CONCLUSIONS Cooking with biomass fuels was associated with depression and anxiety symptoms in order adults. Further large prospective cohort studies are warranted to confirm this association.
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Affiliation(s)
- Yan Deng
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Hang Zhao
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Ying Liu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Huo Liu
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Jingang Shi
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Chenkai Zhao
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China
| | - Miao He
- Department of Environmental Health, School of Public Health, China Medical University, Key Laboratory of Environmental Health Damage Research and Assessment, Shenyang 110122, Liaoning Province, PR China.
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Hernandez I, Gabriel N, He M, Guo J, Tadrous M, Suda KJ, Magnani JW. Effect of the COVID-19 pandemic on adversity in individuals receiving anticoagulation for atrial fibrillation: A nationally representative administrative health claims analysis. AMERICAN HEART JOURNAL PLUS: CARDIOLOGY RESEARCH AND PRACTICE 2022; 13:100096. [PMID: 35136865 PMCID: PMC8815277 DOI: 10.1016/j.ahjo.2022.100096] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/04/2022] [Accepted: 01/17/2022] [Indexed: 11/29/2022]
Abstract
Background Atrial fibrillation (AF) is strongly associated with clinical adversity, including increased hospitalization and bleeding and stroke events. We examined the effect of the SARS-2 Coronavirus 2019 (COVID-19) pandemic on such events in individuals with AF receiving oral anticoagulation. Methods We employed medical and pharmacy claims spanning 2018–2020 from a nationally representative U.S. database (IQVIA Longitudinal Prescription, Medical Claims, and Institutional Claims). We selected individuals receiving oral anticoagulation in 2018 for AF and followed them from 1/1/2019–7/8/2020 for clinical events. We constructed interrupted time-series analyses across 30-day intervals with Poisson regression models to determine the effect of the COVID-19 pandemic on clinical events. Results The dataset included 1,439,145 individuals (half with age ≥75 years; 47.6% women) receiving oral anticoagulation. We determined a 19% decrease in emergency room visits following the pandemic declaration and 8% decrease in inpatient admissions. In contrast admissions for stroke and bleeding were not affected by the declaration of the pandemic. Discussion These results describe the temporal effect of the COVID-19 pandemic on clinical adversity – hospitalizations, strokes, and bleeding events – in individuals receiving oral anticoagulation for AF. Our analysis quantifies the decrease in clinical adversity accompanying COVID-19 in a large, highly representative U.S. health claims database.
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Essien UR, Kornej J, Johnson AE, Schulson LB, Benjamin EJ, Magnani JW. Social determinants of atrial fibrillation. Nat Rev Cardiol 2021; 18:763-773. [PMID: 34079095 PMCID: PMC8516747 DOI: 10.1038/s41569-021-00561-0] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 02/05/2023]
Abstract
Atrial fibrillation affects almost 60 million adults worldwide. Atrial fibrillation is associated with a high risk of cardiovascular morbidity and death as well as with social, psychological and economic burdens on patients and their families. Social determinants - such as race and ethnicity, financial resources, social support, access to health care, rurality and residential environment, local language proficiency and health literacy - have prominent roles in the evaluation, treatment and management of atrial fibrillation. Addressing the social determinants of health provides a crucial opportunity to reduce the substantial clinical and non-clinical complications associated with atrial fibrillation. In this Review, we summarize the contributions of social determinants to the patient experience and outcomes associated with this common condition. We emphasize the relevance of social determinants and their important intersection with atrial fibrillation treatment and outcomes. In closing, we identify gaps in the literature and propose future directions for the investigation of social determinants and atrial fibrillation.
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Affiliation(s)
- Utibe R. Essien
- Division of General Internal Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,
| | - Jelena Kornej
- Sections of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Amber E. Johnson
- Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Lucy B. Schulson
- Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
| | - Emelia J. Benjamin
- Sections of Cardiovascular Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Jared W. Magnani
- Division of Cardiology, Heart and Vascular Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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21
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Jalali S, Karbakhsh M, Momeni M, Taheri M, Amini S, Mansourian M, Sarrafzadegan N. Long-term exposure to PM 2.5 and cardiovascular disease incidence and mortality in an Eastern Mediterranean country: findings based on a 15-year cohort study. Environ Health 2021; 20:112. [PMID: 34711250 PMCID: PMC8555193 DOI: 10.1186/s12940-021-00797-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 10/17/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Evidence concerning the impact of long-term exposure to fine Particulate Matter ≤2.5 μm (PM2.5) on Cardio-Vascular Diseases (CVDs) for those people subject to ambient air pollution in developing countries remains relatively scant. This study assessed the relationship of 15-year PM2.5 exposure with cardiovascular incidence and mortality rate in Isfahan province, Iran. METHODS The cohort comprised 3081 participants over 35 years old who were free of CVDs. They were selected through multi-stage cluster sampling in Isfahan, Iran. PM2.5 exposure was determined separately for each individual via satellite-based spatiotemporal estimates according to their residential addresses. In this context, CVD is defined as either fatal and non-fatal Acute Myocardial Infarctions (AMI) or stroke and sudden cardiac death. The incidence risk for CVD and the ensuing mortality was calculated based on the average PM2.5 exposure within a study period of 15 years using the Cox proportional hazards frailty model upon adjusting individual risk factors. The mean annual rate of PM2.5 and the follow-up data of each residential area were combined. RESULTS Mean three-year PM2·5 exposure for the cohort was measured at 45.28 μg/m3, ranging from 20.01 to 69.80 μg/m3. The median time period for conducting necessary follow-ups was 12.3 years for the whole population. Notably, 105 cardiovascular and 241 all-cause deaths occurred among 393,786 person-months (27 and 61 per 100,000 person-months, respectively). In well-adjusted models, 10 μg/m3 increase in PM2.5 corresponded to a 3% increase in the incidence rate of CVDs [0.95 CI = 1.016, 1.036] (in case of p = 0.000001 per 10 μg/m3 increase in PM2.5, the Hazard Ratio (HR) for AMI and Ischemic Heart Disease (IHD) was 1.031 [0.95 CI = 1.005, 1.057] and 1.028 [0.95 CI = 1.017, 1.039]), respectively. No consistent association was observed between PM2.5 concentration and fatal CVD (fatal AMI, fatal stroke, SCD (Sudden Cardiac Death)) and all-cause mortality. CONCLUSIONS Results from analyses suggest that the effect of PM2.5 on cardiovascular disease occurrence was stronger in the case of older people, smokers, and those with high blood pressure and diabetes. The final results revealed that long-term exposure to ambient PM2.5 with high concentrations positively correlated with IHD incidence and its major subtypes, except for mortality. The outcome accentuates the need for better air quality in many countries.
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Affiliation(s)
- Soheila Jalali
- Student Research Committee, Department of Epidemiology and Biostatistics, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojgan Karbakhsh
- Department of Community and Preventive Medicine, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Momeni
- Department of Surveying Engineering, University of Isfahan, Isfahan, Iran
| | - Marzieh Taheri
- Pediatric Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeid Amini
- Department of Surveying and Geomatics Engineering, University of Isfahan, Isfahan, Iran
| | - Marjan Mansourian
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Automatic Control, Biomedical Engineering Research Center, Universitat Politècnica de Catalunya, BarcelonaTech (UPC), Building H, Floor 4, Av. Diagonal 647, 08028 Barcelona, Spain
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- School of Population & Public Health, University of British Columbia, Vancouver, Canada
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22
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Zhu C, Maharajan K, Liu K, Zhang Y. Role of atmospheric particulate matter exposure in COVID-19 and other health risks in human: A review. ENVIRONMENTAL RESEARCH 2021; 198:111281. [PMID: 33961825 PMCID: PMC8096764 DOI: 10.1016/j.envres.2021.111281] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Revised: 04/17/2021] [Accepted: 04/30/2021] [Indexed: 05/04/2023]
Abstract
Due to intense industrialization and urbanization, air pollution has become a serious global concern as a hazard to human health. Epidemiological studies found that exposure to atmospheric particulate matter (PM) causes severe health problems in human and significant damage to the physiological systems. In recent days, PM exposure could be related as a carrier for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus transmission and Coronavirus disease 2019 (COVID-19) infection. Hence, it is important to understand the adverse effects of PM in human health. This review aims to provide insights on the detrimental effects of PM in various human health problems including respiratory, circulatory, nervous, and immune system along with their possible toxicity mechanisms. Overall, this review highlights the potential relationship of PM with several life-limiting human diseases and their significance for better management strategies.
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Affiliation(s)
- Chengyue Zhu
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China
| | - Kannan Maharajan
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China
| | - Kechun Liu
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China
| | - Yun Zhang
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China; Engineering Research Center of Zebrafish Models for Human Diseases and Drug Screening of Shandong Province, Jinan, Shandong Province, PR China.
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