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Arrúe M, Penalba A, Rodriguez-Bodero A, Elicegui A, de Homdedeu M, Cruz MJ, Simats A, Rodriguez S, Buxó X, Garcia-Rodriguez N, Pizarro J, Turner MC, Delgado P, Rosell A. Diesel exhaust particles exposure exacerbates pro-thrombogenic plasma features ex-vivo after cerebral ischemia and accelerates tPA-induced clot-lysis in hypertensive subjects. J Cereb Blood Flow Metab 2024; 44:772-786. [PMID: 37974302 PMCID: PMC11197133 DOI: 10.1177/0271678x231214826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 10/09/2023] [Accepted: 10/15/2023] [Indexed: 11/19/2023]
Abstract
The combustion of fossil fuels, mainly by diesel engines, generates Diesel Exhaust Particles (DEP) which are the main source of Particulate Matter (PM), a major air pollutant in urban areas. These particles are a risk factor for stroke with 5.6% of cases attributed to PM exposure. Our aim was to evaluate the effect of DEP exposure on clot formation and lysis in the context of stroke. An ex-vivo clot formation and lysis turbidimetric assay has been conducted in human and mouse plasma samples from ischemic stroke or control subjects exposed to DEP or control conditions. Experimental DEP exposure was achieved by nasal instillation in mice, or by ex-vivo exposure in human plasma. Results show consistent pro-thrombogenic features in plasma after human ischemic stroke and mouse cerebral ischemia (distal MCAo), boosted by the presence of DEP. Otherwise, thrombolysis times were increased after ischemia in chronically exposed mice but not in the DEP exposed group. Finally, subjects living in areas with high PM levels presented accelerated thrombolysis compared to those living in low polluted areas. Overall, our results point at a disbalance of the thrombogenic/lytic system in presence of DEP which could impact on ischemic stroke onset, clot size and thrombolytic treatment.
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Affiliation(s)
- Mercedes Arrúe
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Penalba
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Ane Rodriguez-Bodero
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Amaia Elicegui
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Miquel de Homdedeu
- Pneumology Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Ciber de Enfermedades Respiratorias (Ciberes), Madrid, Spain
| | - María-Jesús Cruz
- Pneumology Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Ciber de Enfermedades Respiratorias (Ciberes), Madrid, Spain
| | - Alba Simats
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Susana Rodriguez
- Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
| | - Xavier Buxó
- Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
| | - Nicolás Garcia-Rodriguez
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Unidad de Rehabilitación Neurológica y Daño Cerebral, Hospital Vall d'Hebron, Barcelona, Spain
| | - Jesús Pizarro
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Michelle C Turner
- Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Pilar Delgado
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anna Rosell
- Neurovascular Research Laboratory, Vall d'Hebron Institut de Recerca (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
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2
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Domínguez-Rodríguez A, Baéz-Ferrer N, Avanzas P, Rodríguez S, Abreu-González P, Trujillo-Martin E, Burillo-Putze G, Hernández-Vaquero D. The Association of Desert Dust with the Risk of Acute Coronary Syndrome in Subjects of a Younger Age. J Clin Med 2024; 13:2392. [PMID: 38673666 PMCID: PMC11051357 DOI: 10.3390/jcm13082392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/16/2024] [Accepted: 04/18/2024] [Indexed: 04/28/2024] Open
Abstract
Objectives: Recently, desert dust in Europe has been recognized as a cardiovascular health problem. In Spain, desert dust inflows in recent years have been associated with worsening air quality. The present study examines whether desert dust events are related to the incidence of acute coronary syndrome (ACS) in patients under 55 years of age. Methods: Data from 2416 consecutive patients admitted to a tertiary hospital due to ACS were prospectively analyzed. A case-crossover time-stratified design using Poisson conditional regression models was applied to estimate the impact of desert dust events involving particulate matter concentrations of an aerodynamic diameter <10 μm (PM10) on the incidence of ACS in patients under 55 years of age. Results: Desert dust intrusion on days 0 to 5 before ACS onset showed no significant association with the incidence of ACS in patients under 55 years of age. The incidence rate ratios of PM10 concentrations 1, 2, 3, 3, 4, and 5 days before ACS onset (for changes of 10 µg/m3) were 1.02 (95% CI 0.97-1.1; p = 0.41), 1.01 (95% CI 0.96-1.07; p = 0.66), 0.99 (95% CI 0.94-1.05; p = 0.78), 0.96 (95% CI 0.9-1.02; p = 0.18), and 0.97 (95% CI 0.91-1.04; p = 0.41). Conclusions: Our findings suggest that desert dust is unlikely to be related to the incidence of ACS in patients under 55 years of age.
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Affiliation(s)
- Alberto Domínguez-Rodríguez
- Departamento de Medicina Interna, Universidad de La Laguna, Servicio de Cardiología, Hospital Universitario de Canarias, 38320 Tenerife, Spain
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain;
| | - Néstor Baéz-Ferrer
- Hospital Universitario de Canarias, Servicio de Cardiología, 38320 Tenerife, Spain;
| | - Pablo Avanzas
- Centro de Investigación Biomédica en Red Enfermedades Cardiovasculares (CIBERCV), 28029 Madrid, Spain;
- Cardiology Area, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain;
- Department of Medicine, Faculty of Medicine, Universidad de Oviedo, 33006 Oviedo, Spain
| | - Sergio Rodríguez
- Institute of Natural Products and Agrobiology (IPNA), CSIC, 38206 La Laguna, Spain;
| | - Pedro Abreu-González
- Unidad de Fisiología, Departamento de Ciencias Médicas Básicas, Universidad de la Laguna, 38200 Tenerife, Spain;
| | - Elisa Trujillo-Martin
- Hospital Universitario de Canarias, Servicio de Reumatología, 38320 Tenerife, Spain;
| | - Guillermo Burillo-Putze
- Hospital Universitario de Canarias, Servicio de Urgencias, 38320 Tenerife, Spain;
- Faculty of Health Sciences, Universidad Europea de Canarias, 38320 La Orotava, Spain
| | - Daniel Hernández-Vaquero
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain;
- Cardiac Surgery Department, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain
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3
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De Vita A, Belmusto A, Di Perna F, Tremamunno S, De Matteis G, Franceschi F, Covino M. The Impact of Climate Change and Extreme Weather Conditions on Cardiovascular Health and Acute Cardiovascular Diseases. J Clin Med 2024; 13:759. [PMID: 38337453 PMCID: PMC10856578 DOI: 10.3390/jcm13030759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 02/12/2024] Open
Abstract
Climate change is widely recognized as one of the most significant challenges facing our planet and human civilization. Human activities such as the burning of fossil fuels, deforestation, and industrial processes release greenhouse gases into the atmosphere, leading to a warming of the Earth's climate. The relationship between climate change and cardiovascular (CV) health, mediated by air pollution and increased ambient temperatures, is complex and very heterogeneous. The main mechanisms underlying the pathogenesis of CV disease at extreme temperatures involve several regulatory pathways, including temperature-sympathetic reactivity, the cold-activated renin-angiotensin system, dehydration, extreme temperature-induced electrolyte imbalances, and heat stroke-induced systemic inflammatory responses. The interplay of these mechanisms may vary based on individual factors, environmental conditions, and an overall health background. The net outcome is a significant increase in CV mortality and a higher incidence of hypertension, type II diabetes mellitus, acute myocardial infarction (AMI), heart failure, and cardiac arrhythmias. Patients with pre-existing CV disorders may be more vulnerable to the effects of global warming and extreme temperatures. There is an urgent need for a comprehensive intervention that spans from the individual level to a systemic or global approach to effectively address this existential problem. Future programs aimed at reducing CV and environmental burdens should require cross-disciplinary collaboration involving physicians, researchers, public health workers, political scientists, legislators, and national leaders to mitigate the effects of climate change.
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Affiliation(s)
- Antonio De Vita
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Antonietta Belmusto
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Federico Di Perna
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
| | - Saverio Tremamunno
- Department of Cardiovascular Sciences, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Giuseppe De Matteis
- Department of Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy;
| | - Francesco Franceschi
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
| | - Marcello Covino
- Università Cattolica del Cattolica del Sacro Cuore, 00168 Roma, Italy; (A.B.); (F.D.P.); (F.F.); (M.C.)
- Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Roma, Italy
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Palacio LC, Durango-Giraldo G, Zapata-Hernandez C, Santa-González GA, Uribe D, Saiz J, Buitrago-Sierra R, Tobón C. Characterization of airborne particulate matter and its toxic and proarrhythmic effects: A case study in Aburrá Valley, Colombia. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 336:122475. [PMID: 37652229 DOI: 10.1016/j.envpol.2023.122475] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/15/2023] [Accepted: 08/28/2023] [Indexed: 09/02/2023]
Abstract
Particle matter (PM) is a complex mixture of particles suspended in the air, mainly caused by fuel combustion from vehicles and industry, and has been related to pulmonary and cardiovascular diseases. The Metropolitan Area of Aburrá Valley in Colombia is the second most populous urban agglomeration in the country and the third densest in the world, composed of ten municipalities. Examining the physicochemical properties of PM is crucial in comprehending its composition and its effects on human health, as it varies based on the socioeconomic dynamics specific to each city. This study characterized the PM collected from the north, south, and central zones to evaluate its chemical composition and morphology. Different elements such as silicon, carbon, aluminum, potassium, calcium, sodium, iron, magnesium, and copper and the presence of unburned fuel, motor oil, and silicon fibers were identified. In vitro and in silico studies were conducted to evaluate the toxicity of the PM, and it was found that the PM collected from the central zone had the greatest impact on cell viability and caused DNA damage. The in silico study demonstrated that PM has concentration-dependent proarrhythmic effects, reflected in an action potential duration shortening and an increased number of reentries, which may contribute to the development of cardiac arrhythmias. Overall, the results suggest that the size and chemical composition of ambient PM can induce toxicity and play an important role in the generation of arrhythmias.
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Affiliation(s)
- Laura C Palacio
- MATBIOM, Facultad de Ciencias Básicas, Universidad de Medellín, Medellín, Colombia
| | - Geraldine Durango-Giraldo
- MATyER, Facultad de Ingeniería, Institución Universitaria ITM, Medellín, Colombia; Departament of Textile and Paper Engineering, Polytechnical University of Catalonia, Barcelona, Spain
| | - Camilo Zapata-Hernandez
- MATBIOM, Facultad de Ciencias Básicas, Universidad de Medellín, Medellín, Colombia; MATyER, Facultad de Ingeniería, Institución Universitaria ITM, Medellín, Colombia
| | - Gloria A Santa-González
- GI(2)B, Facultad de Ciencias Exactas y Aplicadas, Institución Universitaria ITM, Medellín, Colombia
| | - Diego Uribe
- GI(2)B, Facultad de Ciencias Exactas y Aplicadas, Institución Universitaria ITM, Medellín, Colombia
| | - Javier Saiz
- CI(2)B, Universitat Politècnica de València, Valencia, Spain
| | | | - Catalina Tobón
- MATBIOM, Facultad de Ciencias Básicas, Universidad de Medellín, Medellín, Colombia.
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Cimmino G, Natale F, Alfieri R, Cante L, Covino S, Franzese R, Limatola M, Marotta L, Molinari R, Mollo N, Loffredo FS, Golino P. Non-Conventional Risk Factors: "Fact" or "Fake" in Cardiovascular Disease Prevention? Biomedicines 2023; 11:2353. [PMID: 37760794 PMCID: PMC10525401 DOI: 10.3390/biomedicines11092353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/18/2023] [Accepted: 08/21/2023] [Indexed: 09/29/2023] Open
Abstract
Cardiovascular diseases (CVDs), such as arterial hypertension, myocardial infarction, stroke, heart failure, atrial fibrillation, etc., still represent the main cause of morbidity and mortality worldwide. They significantly modify the patients' quality of life with a tremendous economic impact. It is well established that cardiovascular risk factors increase the probability of fatal and non-fatal cardiac events. These risk factors are classified into modifiable (smoking, arterial hypertension, hypercholesterolemia, low HDL cholesterol, diabetes, excessive alcohol consumption, high-fat and high-calorie diet, reduced physical activity) and non-modifiable (sex, age, family history, of previous cardiovascular disease). Hence, CVD prevention is based on early identification and management of modifiable risk factors whose impact on the CV outcome is now performed by the use of CV risk assessment models, such as the Framingham Risk Score, Pooled Cohort Equations, or the SCORE2. However, in recent years, emerging, non-traditional factors (metabolic and non-metabolic) seem to significantly affect this assessment. In this article, we aim at defining these emerging factors and describe the potential mechanisms by which they might contribute to the development of CVD.
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Affiliation(s)
- Giovanni Cimmino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Cardiology Unit, Azienda Ospedaliera Universitaria Luigi Vanvitelli, 80138 Naples, Italy
| | - Francesco Natale
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Roberta Alfieri
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Cante
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Simona Covino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Rosa Franzese
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Mirella Limatola
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Luigi Marotta
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Riccardo Molinari
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Noemi Mollo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Francesco S Loffredo
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
| | - Paolo Golino
- Department of Translational Medical Sciences, Section of Cardiology, University of Campania Luigi Vanvitelli, 80131 Naples, Italy (F.S.L.)
- Vanvitelli Cardiology Unit, Monaldi Hospital, 80131 Naples, Italy
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6
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Soldevila N, Vinyoles E, Tobias A, Muñoz-Pérez MÁ, Gorostidi M, de la Sierra A. Effect of air pollutants on ambulatory blood pressure. HIPERTENSION Y RIESGO VASCULAR 2023; 40:119-125. [PMID: 37748946 DOI: 10.1016/j.hipert.2023.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 09/27/2023]
Abstract
BACKGROUND AND METHODOLOGY Air pollutants have a significant impact on public health. The aim of the study was to find out the relationship between ambulatory blood pressure measured by 24-h ambulatory blood pressure monitoring (ABPM) and the atmospheric pollutants that are measured regularly (PM10, PM2.5, NO2 and SO2). An observational study of temporal and geographic measurements of individual patients (case-time series design) was carried out in Primary Care Centres and Hypertension Units in the Barcelona metropolitan area. We included 2888 hypertensive patients≥18 years old, untreated, with a first valid ABPM performed between 2005 and 2014 and with at least one air pollution station within a radius of <3km. RESULTS AND CONCLUSIONS The mean age was 54.3 (SD 14.6) years. 50.1% were women and 16.9% of the sample were smokers. Mean 24-h blood pressure (BP) was 128.0 (12.7)/77.4 (9.7) mmHg. After adjusting for mean ambient temperature and different risk factors, a significant association was found between ambulatory diastolic BP (DBP) and PM10 concentrations the day before ABPM. For each increase of 10μg/m3 of PM10, an increase of 1.37mmHg 24-h DBP and 1.48mmHg daytime DBP was observed. No relationship was found between PM2.5, NO2 and SO2 and ambulatory BP, nor between any pollutant and clinical BP. The concentration of PM10 the day before the ABPM is significantly associated with an increase in 24-h DBP and daytime DBP.
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Affiliation(s)
- N Soldevila
- La Mina Primary Care Health Centre, University of Barcelona, Spain.
| | - E Vinyoles
- La Mina Primary Care Health Centre, University of Barcelona, Spain
| | - A Tobias
- The Spanish National Research Council (CSIC Barcelona), Spain
| | - M Á Muñoz-Pérez
- Cardiovascular Research Group (GRECAP), Catalan Health Institute, Barcelona, Spain
| | - M Gorostidi
- Nephrology Service, Hospital Universitario Central de Asturias, Oviedo, Spain
| | - A de la Sierra
- Hypertension Unit, Hospital Mútua de Terrassa, University of Barcelona, Barcelona, 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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Święczkowski M, Dobrzycki S, Kuźma Ł. Multi-City Analysis of the Acute Effect of Polish Smog on Cause-Specific Mortality (EP-PARTICLES Study). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085566. [PMID: 37107848 PMCID: PMC10139136 DOI: 10.3390/ijerph20085566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/23/2023] [Accepted: 02/27/2023] [Indexed: 05/11/2023]
Abstract
Polish smog is a specific type of air pollution present in Eastern Poland, which may cause particularly adverse cardiovascular effects. It is characterized primarily by high concentrations of particulate matter (PM) and different favorable conditions of formation. Our study aimed to assess whether PM and nitrogen dioxide (NO2) have a short-term impact on mortality due to acute coronary syndrome (ACS) and ischemic stroke (IS). The study covered the years 2016-2020, a total of 6 million person-years from five main cities in Eastern Poland. To evaluate the association between air pollution and cause-specific mortality, a case-crossover study design with conditional logistic regression was used at days with LAG from 0 to 2. We recorded 87,990 all-cause deaths, including 9688 and 3776 deaths due to ACS and IS, respectively. A 10 μg/m3 increase in air pollutants was associated with an increase in mortality due to ACS (PM2.5 OR = 1.029, 95%CI 1.011-1.047, p = 0.002; PM10 OR = 1.015, 95%CI 1-1.029, p = 0.049) on LAG 0. On LAG 1 we recorded an increase in both IS (PM2.5 OR = 1.03, 95%CI 1.001-1.058, p = 0.04) and ACS (PM2.5 OR = 1.028, 95%CI 1.01-1.047, p = 0.003; PM10 OR = 1.026, 95%CI 1.011-1.041, p = 0.001; NO2 OR = 1.036, 95%CI 1.003-1.07, p = 0.04). There was a strong association between air pollution and cause-specific mortality in women (ACS: PM2.5 OR = 1.032, 95%CI 1.006-1.058, p = 0.01; PM10 OR = 1.028, 95%CI 1.008-1.05, p = 0.01) and elderly (ACS: PM2.5 OR = 1.03, 95%CI 1.01-1.05, p = 0.003; PM10 OR = 1.027, 95% CI 1.011-1.043, p < 0.001 and IS: PM2.5 OR = 1.037, 95%CI 1.007-1.069, p = 0.01; PM10 OR = 1.025, 95%CI 1.001-1.05, p = 0.04). The negative influence of PMs was observed on mortality due to ACS and IS. NO2 was associated with only ACS-related mortality. The most vulnerable subgroups were women and the elderly.
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Vaičiulis V, Venclovienė J, Miškinytė A, Ustinavičienė R, Dėdelė A, Kalinienė G, Lukšienė D, Tamošiūnas A, Seiduanova L, Radišauskas R. Association between Outdoor Air Pollution and Fatal Acute Myocardial Infarction in Lithuania between 2006 and 2015: A Time Series Design. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4549. [PMID: 36901560 PMCID: PMC10002310 DOI: 10.3390/ijerph20054549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/26/2023] [Accepted: 03/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Air pollution has a significant effect on human health and there is a broad body of evidence showing that exposure to air pollution is associated with an increased risk of adverse health effects. The main objective of this study was to assess the association of traffic-related air pollutants with fatal AMI during the ten-year period. METHODS The study was conducted in Kaunas city, where the WHO MONICA register included a total of 2273 adult cases of fatal AMI cases during the 10-year study period. We focused on the period between 2006 and 2015. The associations between exposure to traffic-related air pollution and the risk of fatal AMI were evaluated by using a multivariate Poisson regression model, RR presented per an increase in IQR. RESULTS It was found that the risk of fatal AMI was significantly higher in all subjects (RR 1.06; 95% CI 1.00-1.12) and women (RR 1.12; 95% CI 1.02-1.22) when the concentration of PM10 in the ambient air was increased 5-11 days before the onset of AMI, adjusting for NO2 concentration. The effect was stronger during spring in all subjects (RR 1.12; 95% CI 1.03-1.22), in men (RR 1.13; 95% CI 1.01-1.26), in younger-aged (RR 1.15; 95% CI 1.03-1.28), and in winter in women (RR 1.24; 95% CI 1.03-1.50). CONCLUSIONS Our findings show that ambient air pollution increases the risk of fatal AMI, and this pertains to PM10 specifically.
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Affiliation(s)
- Vidmantas Vaičiulis
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Jonė Venclovienė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Auksė Miškinytė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Rūta Ustinavičienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Audrius Dėdelė
- Department of Environmental Sciences, Vytautas Magnus University, Donelaičio St. 58, 44248 Kaunas, Lithuania
| | - Gintarė Kalinienė
- Health Research Institute, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
| | - Dalia Lukšienė
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Abdonas Tamošiūnas
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
| | - Laura Seiduanova
- Department of Health Politics and Management, School of Public Health, Asfendiyarov Kazakh National Medical University, Almaty 050000, Kazakhstan
| | - Ričardas Radišauskas
- Department of Environmental and Occupational Medicine, Lithuanian University of Health Sciences, Tilzes St. 18, 47181 Kaunas, Lithuania
- Institute of Cardiology, Lithuanian University of Health Sciences, Sukileliu Ave. 15, 50162 Kaunas, Lithuania
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BAÑERAS J, IGLESIES-GRAU J, TÉLLEZ-PLAZA M, ARRARTE V, BÁEZ-FERRER N, BENITO B, CAMPUZANO RUIZ R, CECCONI A, DOMÍNGUEZ-RODRÍGUEZ A, RODRÍGUEZ-SINOVAS A, UJUETA F, VOZZI C, LAMAS GA, NAVAS-ACIÉN A. [Environment and cardiovascular health: causes, consequences and opportunities in prevention and treatment]. Rev Esp Cardiol 2022; 75:1050-1058. [PMID: 36570815 PMCID: PMC9785336 DOI: 10.1016/j.recesp.2022.05.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The environment is a strong determinant of cardiovascular health. Environmental cardiology studies the contribution of environmental exposures with the aim of minimizing the harmful influences of pollution and promoting cardiovascular health through specific preventive or therapeutic strategies. The present review focuses on particulate matter and metals, which are the pollutants with the strongest level of scientific evidence, and includes possible interventions. Legislation, mitigation and control of pollutants in air, water and food, as well as environmental policies for heart-healthy spaces, are key measures for cardiovascular health. Individual strategies include the chelation of divalent metals such as lead and cadmium, metals that can only be removed from the body via chelation. The TACT (Trial to Assess Chelation Therapy, NCT00044213) clinical trial demonstrated cardiovascular benefit in patients with a previous myocardial infarction, especially in those with diabetes. Currently, the TACT2 trial (NCT02733185) is replicating the TACT results in people with diabetes. Data from the United States and Argentina have also shown the potential usefulness of chelation in severe peripheral arterial disease. More research and action in environmental cardiology could substantially help to improve the prevention and treatment of cardiovascular disease.
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Affiliation(s)
- Jordi BAÑERAS
- Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | - Josep IGLESIES-GRAU
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canadá
| | - María TÉLLEZ-PLAZA
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, España
| | - Vicente ARRARTE
- Servicio de Cardiología, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, España
| | - Néstor BÁEZ-FERRER
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, España
| | - Begoña BENITO
- Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | - Raquel CAMPUZANO RUIZ
- Servicio de Cardiología, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, España
| | - Alberto CECCONI
- Servicio de Cardiología, Hospital Universitario de la Princesa, Madrid, España
| | - Alberto DOMÍNGUEZ-RODRÍGUEZ
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, España
| | - Antonio RODRÍGUEZ-SINOVAS
- Servei de Cardiologia, Hospital Universitari Vall d’Hebron, Vall d’Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, España
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), España
| | - Francisco UJUETA
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, Estados Unidos
| | - Carlos VOZZI
- Departamento de Cardiología, Instituto Vozzi, Rosario, Argentina
| | - Gervasio A. LAMAS
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, Estados Unidos
- Department of Medicine, Mount Sinai Medical Center, Miami Beach, Florida, Estados Unidos
| | - Ana NAVAS-ACIÉN
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, Nueva York, Estados Unidos
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11
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Bañeras J, Iglesies-Grau J, Téllez-Plaza M, Arrarte V, Báez-Ferrer N, Benito B, Campuzano Ruiz R, Cecconi A, Domínguez-Rodríguez A, Rodríguez-Sinovas A, Ujueta F, Vozzi C, Lamas GA, Navas-Acién A. Environment and cardiovascular health: causes, consequences and opportunities in prevention and treatment. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2022; 75:1050-1058. [PMID: 35931285 PMCID: PMC10266758 DOI: 10.1016/j.rec.2022.05.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
The environment is a strong determinant of cardiovascular health. Environmental cardiology studies the contribution of environmental exposures with the aim of minimizing the harmful influences of pollution and promoting cardiovascular health through specific preventive or therapeutic strategies. The present review focuses on particulate matter and metals, which are the pollutants with the strongest level of scientific evidence, and includes possible interventions. Legislation, mitigation and control of pollutants in air, water and food, as well as environmental policies for heart-healthy spaces, are key measures for cardiovascular health. Individual strategies include the chelation of divalent metals such as lead and cadmium, metals that can only be removed from the body via chelation. The TACT (Trial to Assess Chelation Therapy, NCT00044213) clinical trial demonstrated cardiovascular benefit in patients with a previous myocardial infarction, especially in those with diabetes. Currently, the TACT2 trial (NCT02733185) is replicating the TACT results in people with diabetes. Data from the United States and Argentina have also shown the potential usefulness of chelation in severe peripheral arterial disease. More research and action in environmental cardiology could substantially help to improve the prevention and treatment of cardiovascular disease.
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Affiliation(s)
- Jordi Bañeras
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Josep Iglesies-Grau
- Centre ÉPIC and Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
| | - María Téllez-Plaza
- Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain
| | - Vicente Arrarte
- Servicio de Cardiología, Hospital General Universitario Dr. Balmis, ISABIAL, Alicante, Spain
| | - Néstor Báez-Ferrer
- Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, Spain
| | - Begoña Benito
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Raquel Campuzano Ruiz
- Servicio de Cardiología, Hospital Universitario Fundación de Alcorcón, Alcorcón, Madrid, Spain
| | - Alberto Cecconi
- Servicio de Cardiología, Hospital Universitario de La Princesa, Madrid, Spain
| | - Alberto Domínguez-Rodríguez
- Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain; Servicio de Cardiología, Hospital Universitario de Canarias, Universidad Europea de Canarias, Santa Cruz de Tenerife, Spain
| | - Antonio Rodríguez-Sinovas
- Servei de Cardiologia, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca, Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Cardiovasculares (CIBERCV), Spain
| | - Francisco Ujueta
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, United States
| | - Carlos Vozzi
- Departamento de Cardiología, Instituto Vozzi, Rosario, Argentina
| | - Gervasio A Lamas
- Columbia University Division of Cardiology, Mount Sinai Medical Center, Miami Beach, Florida, United States; Department of Medicine, Mount Sinai Medical Center, Miami Beach, Florida, United States
| | - Ana Navas-Acién
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, Nueva York, United States.
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12
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Influence of air pollutants on circulating inflammatory cells and microRNA expression in acute myocardial infarction. Sci Rep 2022; 12:5350. [PMID: 35354890 PMCID: PMC8967857 DOI: 10.1038/s41598-022-09383-7] [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: 08/27/2021] [Accepted: 03/09/2022] [Indexed: 02/07/2023] Open
Abstract
Air pollutants increase the risk and mortality of myocardial infarction (MI). The aim of this study was to assess the inflammatory changes in circulating immune cells and microRNAs in MIs related to short-term exposure to air pollutants. We studied 192 patients with acute coronary syndromes and 57 controls with stable angina. For each patient, air pollution exposure in the 24-h before admission, was collected. All patients underwent systematic circulating inflammatory cell analyses. According to PM2.5 exposure, 31 patients were selected for microRNA analyses. STEMI patients exposed to PM2.5 showed a reduction of CD4+ regulatory T cells. Furthermore, in STEMI patients the exposure to PM2.5 was associated with an increase of miR-146a-5p and miR-423-3p. In STEMI and NSTEMI patients PM2.5 exposure was associated with an increase of miR-let-7f-5p. STEMI related to PM2.5 short-term exposure is associated with changes involving regulatory T cells, miR-146a-5p and miR-423-3p.
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13
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Pallikadavath S, Vali Z, Patel R, Mavilakandy A, Peckham N, Clegg M, Sandilands AJ, Ng GA. The Influence of Environmental Air Pollution on Ventricular Arrhythmias: A Scoping Review. Curr Cardiol Rev 2022; 18:e160422203685. [PMID: 35430968 PMCID: PMC9893149 DOI: 10.2174/1573403x18666220416203716] [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: 09/08/2021] [Revised: 12/07/2021] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Exposure to air pollution is a recognised risk factor for cardiovascular disease and has been associated with supraventricular arrhythmias. The effect of air pollution on ventricular arrhythmias is less clear. This scoping review assessed the effects of particulate and gaseous air pollutants on the incidence of ventricular arrhythmias. METHODS MEDLINE and EMBASE databases were searched for studies assessing the effects of air pollutants on ventricular tachycardia and ventricular fibrillation. These pollutants were particulate matter (PM) 2.5, PM10, Nitrogen Dioxide (NO2), Carbon Monoxide (CO), Sulphur Dioxide (SO2), and Ozone (O3). RESULTS This review identified 27 studies: nine in individuals with implantable cardioverter defibrillators, five in those with ischaemic heart disease, and 13 in the general population. Those with ischaemic heart disease appear to have the strongest association with ventricular arrhythmias in both gaseous and particulate pollution, with all three studies assessing the effects of PM2.5 demonstrating some association with ventricular arrythmia. Results in the general and ICD population were less consistent. CONCLUSION Individuals with ischaemic heart disease may be at an increased risk of ventricular arrhythmias following exposure to air pollution.
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Affiliation(s)
- Susil Pallikadavath
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Zakariyya Vali
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Roshan Patel
- Leicester Medical School, College of Life Sciences, University of Leicester, UK
| | - Akash Mavilakandy
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - Nicholas Peckham
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - Matt Clegg
- Department of Geography, University of Birmingham, Birmingham, UK
| | - Alastair J. Sandilands
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
| | - G. André Ng
- Department of Cardiovascular Sciences, University of Leicester and the NIHR Leicester Biomedical Research Centre, Glenfield Hospital, Leicester, UK
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Liu L, Zhu Y, Xu H, Wang Y, Wang T, Zhao Q, Zhang Y, Chen J, Liu S, Yi T, Wu R, Liu S, Song X, Li J, Huang W. Short-term exposure to ambient ozone associated with cardiac arrhythmias in healthy adults. GLOBAL HEALTH JOURNAL 2022. [DOI: 10.1016/j.glohj.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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15
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Zhang H, Yi M, Wang Y, Zhang Y, Xiao K, Si J, Shi N, Sun L, Miao Z, Zhao T, Sun X, Liu Z, Gao J, Li J. Air pollution and recurrence of cardiovascular events after ST-segment elevation myocardial infarction. Atherosclerosis 2021; 342:1-8. [PMID: 34974197 DOI: 10.1016/j.atherosclerosis.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 12/12/2021] [Accepted: 12/17/2021] [Indexed: 11/02/2022]
Abstract
BACKGROUND AND AIMS The effects of air pollution on discharged patients after ST-segment elevation myocardial infarction (STEMI) still remain uncertain. We examined the association between air pollutants and recurrent cardiovascular events in STEMI survivors. METHODS A retrospective cohort of 1641 discharged patients after STEMI was established in 2013 and followed until the end of 2019. Concentrations of air pollutants including fine particles <2.5 μm aerodynamic diameter (PM2.5), inhalable particles <10 μm aerodynamic diameter (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO) and ozone (O3) measured by fixed ambient air monitoring stations were collected for exposure assessment. Multivariate-adjusted Cox proportional hazards models were used to estimate the increased risks of recurrent cardiovascular events. RESULTS Compared with the first exposure quartile, for short-term exposure, hazard ratios (HRs) of recurrent cardiovascular events associated with the fourth exposure quartiles of PM2.5, PM10, NO2, SO2, CO, and O3 were 4.06 (95% CI: 2.62-6.30), 3.79 (95% CI: 2.57-5.58), 2.22 (95% CI: 1.67-2.94), 4.47 (95% CI: 3.08-6.48), 3.73 (95% CI: 2.54-5.48), and 5.35 (95% CI: 3.12-9.20), respectively. For long-term exposure, HRs associated with the fourth exposure quartiles of PM2.5, PM10, NO2, SO2, CO, and O3 were 6.43 (95% CI: 3.60-11.47), 4.77 (95% CI: 2.85-7.99), 3.22 (95% CI: 2.00-5.19), 3.20 (95% CI: 2.05-5.01), 4.44 (95% CI: 2.65-7.45), and 1.07 (95% CI: 0.80-1.42), respectively. The risks of recurrent cardiovascular events brought by air pollutants mostly increased nonlinearly. CONCLUSIONS Short- and long-term exposure to air pollutants except ozone increases the risks of recurrent cardiovascular events in STEMI survivors. Better environmental policies and secondary prevention strategies should be developed to protect STEMI survivors as a susceptible population.
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Affiliation(s)
- Haoyu Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ming Yi
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Capital Medical University, Beijing, 100069, China
| | - Yang Wang
- Medical Research & Biometrics Center, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, China
| | - Yinghua Zhang
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Keling Xiao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jin Si
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ning Shi
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Lijie Sun
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Zupei Miao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Ting Zhao
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Xipeng Sun
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Zhi Liu
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jing Gao
- Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China
| | - Jing Li
- Department of Geriatrics, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, 100053, China; Department of Cardiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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Effects of Fine Particulate Matter and Its Components on Emergency Room Visits for Pediatric Pneumonia: A Time-Stratified Case-Crossover Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182010599. [PMID: 34682345 PMCID: PMC8535937 DOI: 10.3390/ijerph182010599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/07/2021] [Accepted: 10/08/2021] [Indexed: 11/17/2022]
Abstract
Pneumonia, one of the important causes of death in children, may be induced or aggravated by particulate matter (PM). Limited research has examined the association between PM and its constituents and pediatric pneumonia-related emergency department (ED) visits. Measurements of PM2.5, PM10, and four PM2.5 constituents, including elemental carbon (EC), organic carbon (OC), nitrate, and sulfate, were extracted from 2007 to 2010 from one core station and two satellite stations in Kaohsiung City, Taiwan. Furthermore, the medical records of patients under 17 years old who had visited the ED in a medical center and had a diagnosis of pneumonia were collected. We used a time-stratified, case-crossover study design to estimate the effect of PM. The single-pollutant model demonstrated interquartile range increase in PM2.5, PM10, nitrate, OC, and EC on lag 3, which increased the risk of pediatric pneumonia by 18.2% (95% confidence interval (Cl), 8.8-28.4%), 13.1% (95% CI, 5.1-21.7%), 29.7% (95% CI, 16.4-44.5%), 16.8% (95% CI, 4.6-30.4%), and 14.4% (95% Cl, 6.5-22.9%), respectively. After PM2.5, PM10, and OC were adjusted for, nitrate and EC remained significant in two-pollutant models. Subgroup analyses revealed that nitrate had a greater effect on children during the warm season (April to September, interaction p = 0.035). In conclusion, pediatric pneumonia ED visit was related to PM2.5 and its constituents. Moreover, PM2.5 constituents, nitrate and EC, were more closely associated with ED visits for pediatric pneumonia, and children seemed to be more susceptible to nitrate during the warm season.
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Domínguez-Rodríguez A, Rodríguez S, Baez-Ferrer N, Avanzas P, Abreu-González P, Silva J, Morís C, Hernández-Vaquero D. Impacto del polvo sahariano en la incidencia de síndrome coronario agudo. Rev Esp Cardiol (Engl Ed) 2021. [DOI: 10.1016/j.recesp.2020.01.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Jaafari J, Naddafi K, Yunesian M, Nabizadeh R, Hassanvand MS, Shamsipour M, Ghanbari Ghozikali M, Nazmara S, Shamsollahi HR, Yaghmaeian K. Associations between short term exposure to ambient particulate matter from dust storm and anthropogenic sources and inflammatory biomarkers in healthy young adults. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:144503. [PMID: 33352344 DOI: 10.1016/j.scitotenv.2020.144503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Revised: 11/18/2020] [Accepted: 12/10/2020] [Indexed: 05/13/2023]
Abstract
This study examined the association between particulate matter from anthropogenic and natural sources and inflammatory biomarkers, including hs-CRP, IL-6, sTNF-RII, and WBCs, in two groups of healthy young subjects. We followed up subjects of two panels (16 to 22 years old), including 22 subjects selected from the urban area (Tehran city) with high-level pollution background and 22 subjects selected from the rural area (Ahmadabad) with low-level pollution background. In each group, we collected 4 times blood samples in various air pollution conditions, In the subjects of the urban group, there was a substantial difference (p < 0.05) between inversion days and cold season control days, and between dust storm days and warm season control days for concentrations of hs-CRP, IL-6, and WBCs biomarkers. In the subjects of the rural group, a significant difference could be detected in the concentration of hs-CRP, IL-6, and WBCs biomarkers (p < 0.05) between inversion days and cold season control days, and between dust storm and warm control days. We found that the difference in concentrations of hs-CRP, IL-6, and WBCs biomarkers between dust storm days and warm control conditions in the rural group were higher than the difference in inversion and cold control conditions, which can be attributed to low background air pollution in the rural area. In the urban area, the health effect of anthropogenic sources of PM is higher than the dust storm condition, which can be attributed to the stronger effect of anthropogenic pollution effect.
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Affiliation(s)
- Jalil Jaafari
- Research Center of Health and Environment, School of Health, Guilan University of Medical Sciences, Rasht, Iran; Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Kazem Naddafi
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Masud Yunesian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran; Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Ramin Nabizadeh
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadegh Hassanvand
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran.
| | - Mansour Shamsipour
- Department of Research Methodology and Data Analysis, Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | | | - Shahrokh Nazmara
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamid Reza Shamsollahi
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Kamyar Yaghmaeian
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran; Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
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Domínguez-Rodríguez A, Báez-Ferrer N, Abreu-González P, Rodríguez S, Díaz R, Avanzas P, Hernández-Vaquero D. Impact of Desert Dust Events on the Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Clin Med 2021; 10:jcm10040727. [PMID: 33673156 PMCID: PMC7918944 DOI: 10.3390/jcm10040727] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/04/2021] [Accepted: 02/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Whether or not inhalation of airborne desert dust has adverse health effects is unknown. The present study, based on a systematic review and meta-analysis, was carried out to assess the influence desert dust on cardiovascular mortality, acute coronary syndrome, and heart failure. Methods: A systematic search was made in PubMed and Embase databases for studies published before March 2020. Studies based on daily measurements of desert dust were identified. The meta-analysis evaluated the impact of desert dust on cardiovascular events the same day (lag 0) of the exposure and during several days after the exposure (lags 1 to 5). The combined impact of several days of exposure was also evaluated. The incidence rate ratio (IRR) with 95% confidence intervals (CI) was calculated using the inverse variance random effects method. Results: Of the 589 identified titles, a total of 15 studies were selected. The impact of desert dust on the incidence of cardiovascular mortality was statistically significant (IRR = 1.018 (95%CI 1.008–1.027); p < 0.001) in lag 0 of the dust episode, in the following day (lag 1) (IRR = 1.005 (95%CI 1.001–1.009); p = 0.022), and during both days combined (lag 0–1) (IRR = 1.015 (95%CI 1.003–1.028); p = 0.014). Conclusions: The inhalation to desert dust results in a 2% increase (for every 10 µg/m3) in cardiovascular mortality risk.
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Affiliation(s)
- Alberto Domínguez-Rodríguez
- Servicio de Cardiología, Hospital Universitario de Canarias, 38010 Tenerife, Spain;
- Departamento de Enfermería, Universidad de La Laguna, 38200 Tenerife, Spain
- CIBER de Enfermedades CardioVasculares (CIBERCV), 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-922-679040; Fax: +34-922-678460
| | - Néstor Báez-Ferrer
- Servicio de Cardiología, Hospital Universitario de Canarias, 38010 Tenerife, Spain;
| | - Pedro Abreu-González
- Departamento de Fisiología, Facultad de Medicina, Universidad de La Laguna, 38200 Tenerife, Spain;
| | - Sergio Rodríguez
- Estación Experimental de Zonas Áridas, EEZA, CSIC, 04120 Almería, Spain;
- Instituto de Productos Naturales y Agrobiología, IPNA, CSIC, 38206 Tenerife, Spain
| | - Rocío Díaz
- Área del Corazón, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (R.D.); (P.A.); (D.H.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
| | - Pablo Avanzas
- Área del Corazón, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (R.D.); (P.A.); (D.H.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
- Departamento de Medicina, Universidad de Oviedo, 33003 Asturias, Spain
| | - Daniel Hernández-Vaquero
- Área del Corazón, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain; (R.D.); (P.A.); (D.H.-V.)
- Instituto de Investigación Sanitaria del Principado de Asturias, 33011 Oviedo, Spain
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Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2021; 33:85-107. [PMID: 33495044 DOI: 10.1016/j.arteri.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022]
Abstract
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.
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21
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Teye SO, Yanosky JD, Cuffee Y, Weng X, Luquis R, Farace E, Wang L. Association between blood lead levels and blood pressure in American adults: results from NHANES 1999-2016. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2020; 27:45836-45843. [PMID: 32803607 DOI: 10.1007/s11356-020-10381-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 08/03/2020] [Indexed: 06/11/2023]
Abstract
The aim of this study was to investigate the association between blood lead level (BLL) and hypertension in adults when lead exposure for the general population is low. The study used data from the US National Health and Nutrition Examination Survey (NHANES) 1999-2016. Participants aged 20 to 79 years were included in our study. Weighted multiple linear regression and logistic regression were conducted to test the association between BLL and systolic/diastolic blood pressure and hypertension status, respectively, while controlling for age, gender, race/ethnicity, body mass index, income level, and education. A total of 30,467 participants were included in this study. There was no association between BLL and hypertension status for the overall sample. Among those who were not taking antihypertensive medication, after adjusting for covariates, systolic blood pressure was positively correlated with BLL in non-Hispanic Whites (P = 0.004) and non-Hispanic Blacks (P = 0.0005), but not Hispanics (P = 0.07) nor Others (P = 0.37). The relationship between diastolic blood pressure and lead levels was also significant in non-Hispanic Whites and non-Hispanic Blacks. This study showed that higher BLL was associated with higher systolic and diastolic blood pressure in some population groups, but not associated with hypertension status.
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Affiliation(s)
- Simisola O Teye
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | - Jeff D Yanosky
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Yendelela Cuffee
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Xingran Weng
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Raffy Luquis
- School of Behavioral Sciences and Education, Penn State Harrisburg, Middletown, PA, USA
| | - Elana Farace
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
- Department of Neurosurgery, Penn State College of Medicine, Hershey, PA, USA
| | - Li Wang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
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Armario P, Brotons C, Elosua R, Alonso de Leciñana M, Castro A, Clarà A, Cortés O, Díaz Rodriguez Á, Herranz M, Justo S, Lahoz C, Pedro-Botet J, Pérez Pérez A, Santamaria R, Tresserras R, Aznar Lain S, Royo-Bordonada MÁ. [Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines]. HIPERTENSION Y RIESGO VASCULAR 2020; 38:21-43. [PMID: 33069629 DOI: 10.1016/j.hipert.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 12/23/2022]
Abstract
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.
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Affiliation(s)
- Pedro Armario
- Sociedad Española-Liga Española para la Lucha contra la Hipertensión Arterial, Madrid, España.
| | - Carlos Brotons
- Sociedad Española de Medicina de Familia y Comunitaria, Barcelona, España
| | | | | | - Almudena Castro
- Sociedad Española de Cardiología-Coordinadora Nacional Sección de Prevención, Madrid, España
| | - Albert Clarà
- Sociedad Española de Angiología y Cirugía Vascular, Madrid, España
| | - Olga Cortés
- Asociación Española Pediatría de Atención Primaria, Madrid, España
| | | | - María Herranz
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria-FAECAP, Madrid, España
| | | | - Carlos Lahoz
- Sociedad Española de Medicina Interna, Madrid, España
| | | | | | | | - Ricard Tresserras
- Sociedad Española de Salud Pública y Administración Sanitaria-SESPAS, Barcelona, España
| | - Susana Aznar Lain
- Facultad de Ciencias del Deporte, Universidad Castilla La Mancha, Toledo, España
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Hung CS, Huang CC, Pan SC, Ma HP, Huang CC, Guo YLL, Ho YL. Acute particulate matter exposure is associated with disturbances in heart rate complexity in patients with prior myocardial infarction. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 733:138842. [PMID: 32446047 DOI: 10.1016/j.scitotenv.2020.138842] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/14/2020] [Accepted: 04/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Ambient air pollutants can increase cardiovascular mortality. One possible mechanism is the effect on the autonomic balance of the cardiovascular system. Studies on acute effects of particulate matter (PM) exposure on heart rate variability (HRV), a surrogate marker for autonomic balance, in patients with prior myocardial infarction (MI) revealed inconsistent results. METHOD We prospectively enrolled participants with acute MI. These participants received a 24-hour Holter electrocardiography examination and echocardiography six months after the index MI. Linear [standard deviation of all normal to normal intervals, standard deviation of NN intervals (SDNN), and a low-frequency to high-frequency ratio (LF/HF)] and non-linear parameters of heart rate variability [multiscale entropy (MSE)] were calculated to show autonomic balance. Data for PM2.5, PM2.5-10, and PM10, were obtained from a fixed-site station in Taiwan. Linear mixed effect models were used to estimate acute effects (within 0-3 days) of PM exposure (per 10 μg/m3) on heart rate variability. RESULTS A total of 90 participants were enrolled in this study with a mean age of 58.7 (13.3) and 83 (92.2%) male participants. Traditional HRV parameters, SDNN and LF/HF, were positively correlated with two-day lagged PM2.5-10 and PM10 [adjusted beta coefficient: SDNN: 130.3 and 58.5; LH/HF: 0.32 and 0.21 (all p < or = 0.01)]. MSE slopes 1-5 were negatively correlated with same-day PM2.5-10 and PM10 (adjusted beta coefficient -0.011 (p = 0.01) and -0.005 (p = 0.02), respectively). The left ventricular ejection fraction was negatively correlated with one-day lagged PM2.5-10, and PM10 (adjusted beta coefficient -0.49 and -0.4, respectively; both p < 0.05), after adjusting for MI size. CONCLUSION Our results suggest that coarse PM may acutely affect cardiac autonomic balance. MSE is a sensitive marker for detecting changes in autonomic imbalance in patients with prior MI following acute PM exposure.
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Affiliation(s)
- Chi-Sheng Hung
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Chang Huang
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Shih-Chun Pan
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan
| | - Hsi-Pin Ma
- Department of Electrical Engineering, National Tsing Hua University, Hsinchu, Taiwan
| | - Ching-Chun Huang
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, Taipei, Taiwan
| | - Yue-Liang Leon Guo
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University, Taipei, Taiwan; Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and NTU Hospital, Taipei, Taiwan.
| | - Yi-Lwun Ho
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Telehealth Center, National Taiwan University Hospital, Taipei, Taiwan.
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Stieb DM, Zheng C, Salama D, BerjawI R, Emode M, Hocking R, Lyrette N, Matz C, Lavigne E, Shin HH. Systematic review and meta-analysis of case-crossover and time-series studies of short term outdoor nitrogen dioxide exposure and ischemic heart disease morbidity. Environ Health 2020; 19:47. [PMID: 32357902 PMCID: PMC7195719 DOI: 10.1186/s12940-020-00601-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 04/20/2020] [Indexed: 05/25/2023]
Abstract
BACKGROUND Nitrogen dioxide (NO2) is a pervasive urban pollutant originating primarily from vehicle emissions. Ischemic heart disease (IHD) is associated with a considerable public health burden worldwide, but whether NO2 exposure is causally related to IHD morbidity remains in question. Our objective was to determine whether short term exposure to outdoor NO2 is causally associated with IHD-related morbidity based on a synthesis of findings from case-crossover and time-series studies. METHODS MEDLINE, Embase, CENTRAL, Global Health and Toxline databases were searched using terms developed by a librarian. Screening, data extraction and risk of bias assessment were completed independently by two reviewers. Conflicts between reviewers were resolved through consensus and/or involvement of a third reviewer. Pooling of results across studies was conducted using random effects models, heterogeneity among included studies was assessed using Cochran's Q and I2 measures, and sources of heterogeneity were evaluated using meta-regression. Sensitivity of pooled estimates to individual studies was examined using Leave One Out analysis and publication bias was evaluated using Funnel plots, Begg's and Egger's tests, and trim and fill. RESULTS Thirty-eight case-crossover studies and 48 time-series studies were included in our analysis. NO2 was significantly associated with IHD morbidity (pooled odds ratio from case-crossover studies: 1.074 95% CI 1.052-1.097; pooled relative risk from time-series studies: 1.022 95% CI 1.016-1.029 per 10 ppb). Pooled estimates for case-crossover studies from Europe and North America were significantly lower than for studies conducted elsewhere. The high degree of heterogeneity among studies was only partially accounted for in meta-regression. There was evidence of publication bias, particularly for case-crossover studies. For both case-crossover and time-series studies, pooled estimates based on multi-pollutant models were smaller than those from single pollutant models, and those based on older populations were larger than those based on younger populations, but these differences were not statistically significant. CONCLUSIONS We concluded that there is a likely causal relationship between short term NO2 exposure and IHD-related morbidity, but important uncertainties remain, particularly related to the contribution of co-pollutants or other concomitant exposures, and the lack of supporting evidence from toxicological and controlled human studies.
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Affiliation(s)
- David M. Stieb
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC V6C 1A1 Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Carine Zheng
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Dina Salama
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Rania BerjawI
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Monica Emode
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Robyn Hocking
- Learning, Knowledge and Library Services, Health Canada, Ottawa, Canada
| | - Ninon Lyrette
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Carlyn Matz
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Eric Lavigne
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
- Water and Air Quality Bureau, Health, Canada, Ottawa, Canada
| | - Hwashin H. Shin
- Environmental Health Science and Research Bureau, Health Canada, 420-757 West Hastings St. - Federal Tower, Vancouver, BC V6C 1A1 Canada
- Department of Mathematics and Statistics, Queen’s University, Kingston, Canada
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Farhadi Z, Abulghasem Gorgi H, Shabaninejad H, Aghajani Delavar M, Torani S. Association between PM 2.5 and risk of hospitalization for myocardial infarction: a systematic review and a meta-analysis. BMC Public Health 2020; 20:314. [PMID: 32164596 PMCID: PMC7068986 DOI: 10.1186/s12889-020-8262-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 01/22/2020] [Indexed: 12/11/2022] Open
Abstract
Background It is generally assumed that there have been mixed results in the literature regarding the association between ambient particulate matter (PM) and myocardial infarction (MI). The aim of this meta-analysis was to explore the rate of short-term exposure PM with aerodynamic diameters ≤2.5 μm (PM2.5) and examine its potential effect(s) on the risk of MI. Methods A systematic search was conducted on databases like PubMed, Scopus, Web of Science, and Embase with components: “air pollution” and “myocardial infarction”. The summary relative risk (RR) and 95% confidence intervals (95%CI) were also calculated to assess the association between the PM2.5 and MI. Results Twenty-six published studies were ultimately identified as eligible candidates for the meta-analysis of MI until Jun 1, 2018. The results illustrated that a 10-μg/m 3 increase in PM2.5 was associated with the risk of MI (RR = 1.02; 95% CI 1.01–1.03; P ≤ 0.0001). The heterogeneity of the studies was assessed through a random-effects model with p < 0.0001 and the I2 was 69.52%, indicating a moderate degree of heterogeneity. We also conducted subgroup analyses including study quality, study design, and study period. Accordingly, it was found that subgroups time series study design and high study period could substantially decrease heterogeneity (I2 = 41.61, 41.78). Conclusions This meta-analysis indicated that exposure – response between PM2.5 and MI. It is vital decision makers implement effective strategies to help improve air pollution, especially in developing countries or prevent exposure to PM2.5 to protect human health.
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Affiliation(s)
- Zeynab Farhadi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hasan Abulghasem Gorgi
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. .,Department of Health Economics, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Hosein Shabaninejad
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mouloud Aghajani Delavar
- Infertility and Reproductive Health Research Center, Research Institute for Health, Babol University of Medical Sciences, Babol, Iran
| | - Sogand Torani
- Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
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Domínguez-Rodríguez A, Rodríguez S, Baez-Ferrer N, Avanzas P, Abreu-González P, Silva J, Morís C, Hernández-Vaquero D. Impact of Saharan dust on the incidence of acute coronary syndrome. ACTA ACUST UNITED AC 2020; 74:321-328. [PMID: 32127342 DOI: 10.1016/j.rec.2020.02.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2019] [Accepted: 01/24/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND OBJECTIVES Asian desert dust has recently been recognized as a trigger for acute myocardial infarction. The inflow of dust from the Sahara into Spain impairs air quality due to an increase in particulate matter concentrations in the ambient air. The aim of the present study was to elucidate whether Saharan dust events are associated with the incidence of acute coronary syndrome (ACS) in patients living near North Africa, the major global dust source. METHODS We prospectively collected data on hospitalizations due to ACS in 2416 consecutive patients from a tertiary care hospital (Canary Islands, Spain) from December 2012 to December 2017. Concentrations of particulate matter with an aerodynamic diameter 10 microns or smaller (PM10) and reactive gases were measured in the European Air Quality Network implemented in the Canary Islands. We applied the time-stratified case crossover design using conditional Poisson regression models to estimate the impact of PM10 Saharan dust events on the incidence of ACS. RESULTS The occurrence of Saharan dust events observed 0 to 5 days before the onset of ACS was not significantly associated with the incidence of ACS. Incidence rate ratios (IRR) of PM10 levels 1, 2, 3, 4 and 5 days before ACS onset (for changes in 10μg/m3) were 1.27 (95%CI, 0.87-1.85), 0.92 (95%CI, 0.84-1.01), 0.74 (95%CI, 0.45-1.22), 0.98 (95%CI, 0.87-1.11), and 0.95 (95%CI, 0.84-1.06), respectively. CONCLUSIONS Exposure to Saharan desert dust is unlikely to be associated with the incidence of ACS.
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Affiliation(s)
- Alberto Domínguez-Rodríguez
- Servicio de Cardiología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain; Facultad de Ciencias de la Salud, Universidad Europea de Canarias, La Orotava, Santa Cruz de Tenerife, Spain; Centro de Investigación Biomédica en Red Enfermedades Cardiovaculares (CIBERCV), Madrid, Spain.
| | - Sergio Rodríguez
- Estación Experimental de Zonas Áridas (EEZA), Consejo Superior de Investigaciones Científicas (CSIC), Almería, Spain; Instituto de Productos Naturales y Agrobiología (IPNA), Consejo Superior de Investigaciones Científicas (CSIC), San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Néstor Baez-Ferrer
- Servicio de Cardiología, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain
| | - Pablo Avanzas
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Pedro Abreu-González
- Departamento de Fisiología, Facultad de Medicina, Universidad de La Laguna, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Jacobo Silva
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - César Morís
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain; Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
| | - Daniel Hernández-Vaquero
- Área del Corazón, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Asturias, Spain
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Short-Term Effects of Ambient Air Pollution on ST-Elevation Myocardial Infarction Events: Are There Potentially Susceptible Groups? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193760. [PMID: 31591299 PMCID: PMC6801768 DOI: 10.3390/ijerph16193760] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 09/29/2019] [Accepted: 10/02/2019] [Indexed: 11/17/2022]
Abstract
Background: Air pollution exposure is associated with greater risk for cardiovascular events. This study aims to examine the effects of increased exposure to short-term air pollutants on ST-segment elevation myocardial infarction (STEMI) and determine the susceptible groups. Methods: Data on particulate matter PM2.5 and PM10 and other air pollutants, measured at each of the 11 air-quality monitoring stations in Kaohsiung City, were collected between 2011 and 2016. The medical records of non-trauma adult (>17 years) patients who had visited the emergency department (ED) with a typical electrocardiogram change of STEMI were extracted. A time-stratified and case-crossover study design was used to examine the relationship between air pollutants and daily ED visits for STEMI. Results: An interquartile range increment in PM2.5 on lag 0 was associated with an increment of 25.5% (95% confidence interval, 2.6%–53.4%) in the risk of STEMI ED visits. Men and persons with ≥3 risk factors (male sex, age, hypertension, diabetes, current smoker, dyslipidemia, history of myocardial infarction, and high body mass index) for myocardial infarction (MI) were more sensitive to the hazardous effects of PM2.5 (interaction: p = 0.039 and p = 0.018, respectively). The associations between PM10, NO2, and O3 and STEMI did not achieve statistical significance. Conclusion: PM2.5 may play an important role in STEMI events on the day of exposure in Kaohsiung. Men and persons with ≥3 risk factors of MI are more susceptible to the adverse effects of PM2.5 on STEMI.
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Li J, Liu C, Cheng Y, Guo S, Sun Q, Kan L, Chen R, Kan H, Bai H, Cao J. Association between ambient particulate matter air pollution and ST-elevation myocardial infarction: A case-crossover study in a Chinese city. CHEMOSPHERE 2019; 219:724-729. [PMID: 30557729 DOI: 10.1016/j.chemosphere.2018.12.094] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 12/09/2018] [Accepted: 12/11/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Abundant epidemiological studies have revealed that short-term exposure to ambient air pollution increased the incidence of ischemic heart diseases. However, few investigations have explored the association between air pollution and ST-elevation myocardial infarction (STEMI), one major subtype of such events. METHODS We conducted a time-stratified case-crossover study in two major hospitals of Yancheng, a city in East China, from January 2015 to February 2018. We used conditional logistic regression models to explore the association between hourly concentrations of air pollutants and STEMI hospitalizations. We explored potential effect modification in susceptible subgroups by age, gender, smoking status, and comorbidities. Two-pollutant models were fitted to test the robustness of the association. RESULTS We identified a total of 347 STEMI patients. In single-pollutant models, each 10 μg/m3 increase in concentrations of fine and inhalable particulate matter (PM) (lag 13-24 h) was associated with increments of 5.27% [95% confidence interval (CI): 1.09%, 9.46%] and 3.86% (95%CI: 0.83%, 6.88%) in STEMI hospitalizations, respectively. We observed slightly larger associations of STEMI hospitalization with PM in patients who were older than 65, female, non-smoker, and with comorbidities (hypertension, diabetes or hyperlipidemia). The associations were generally robust to adjustment of criteria gaseous pollutants except for carbon monoxide. CONCLUSION This is the first study in China that suggested acute exposure to elevated PM concentrations may trigger STEMI. Patients with cardiometabolic comorbidities were slightly more susceptible to air pollution.
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Affiliation(s)
- Jiading Li
- Department of Cardiology, Yancheng Hospital Affiliated to Xuzhou Medical University and the First Hospital of Yancheng, Yancheng, 224006, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Yuexin Cheng
- Department of Hematology, Yancheng Hospital Affiliated to Xuzhou Medical University. the First Hospital of Yancheng, Yancheng, 224006, China
| | - Shumei Guo
- Department of Cardiology, Yancheng Hospital Affiliated to Xuzhou Medical University and the First Hospital of Yancheng, Yancheng, 224006, China
| | - Qian Sun
- Department of Respiratory Medicine, Yancheng Hospital Affiliated to Xuzhou Medical University. the First Hospital of Yancheng, Yancheng, 224006, China
| | - Lena Kan
- UC Berkeley School of Public Health, 50 University Ave Hall, Berkeley, CA, 94720, USA
| | - Renjie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education, Fudan University, Shanghai, 200032, China
| | - Hongjian Bai
- Department of Respiratory Medicine, Yancheng Hospital Affiliated to Xuzhou Medical University. the First Hospital of Yancheng, Yancheng, 224006, China.
| | - Jingyan Cao
- Department of Cardiology, Yancheng Hospital Affiliated to Xuzhou Medical University and the First Hospital of Yancheng, Yancheng, 224006, China.
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Abstract
Approaches to personalized therapy based on practical work of physicians are discussed. Personalized treatment considers patient’s interests and position, mechanisms of symptoms, somatic and mental comorbidities, chrono medicine, environment, genetics, and prognosis. Personalized treatment may be more effective, safe and inexpensive in compare with of traditional standardized care based on randomized controlled trials and clinical practice guidelines. Limitations and weaknesses of medical guidelines of authoritative professional societies are also discussed. Recommendations of clinical guidelines are based on randomized controlled trials with strict selection of patients without severe comorbid diseases. Accordingly, trials and guidelines conclusions cannot be applied for patients with heavy comorbidity. This justifies the need for organizational solutions and computer programs for support personalized treatment of patients. It is important to develop institute of primary care physicians and to train specialists in field of comorbid somatic diseases and mental disorders.
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