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Goto D, Yanishi K, Ozawa T, Yoshimura J, Kawamata H, Fujioka A, Seki T, Zen K, Matoba S. Comparison of Endovascular Therapy and Open Surgical Revascularization in Patients With Acute Superior Mesenteric Artery Occlusion: A Large-Scale Analysis Based on the JROAD-DPC Database. J Am Heart Assoc 2024; 13:e035017. [PMID: 38879458 DOI: 10.1161/jaha.124.035017] [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: 02/15/2024] [Accepted: 05/23/2024] [Indexed: 06/19/2024]
Abstract
BACKGROUND Acute mesenteric ischemia is rare, and few large-scale trials have evaluated endovascular therapy (EVT) and open surgical revascularization (OS). This study aimed to assess clinical outcomes after EVT or OS for acute superior mesenteric artery occlusion and identify predictors of mortality and bowel resection. METHODS AND RESULTS Data from the Japanese Registry of All Cardiac and Vascular Diseases-Diagnosis Procedure Combination (JROAD-DPC) database from April 2012 to March 2020 were retrospectively analyzed. Overall, 746 patients with acute superior mesenteric artery occlusion who underwent revascularization were classified into 2 groups: EVT (n=475) or OS (n=271). The primary clinical outcome was in-hospital mortality. The secondary outcomes were bowel resection, bleeding complications (transfusion or endoscopic hemostasis), major adverse cardiovascular events, hospitalization duration, and cost. The in-hospital death or bowel resection rate was ≈30%. In-hospital mortality (22.5% versus 21.4%, P=0.72), bowel resection (8.2% versus 8.5%, P=0.90), and major adverse cardiovascular events (11.6% versus 9.2%, P=0.32) were comparable between the EVT and OS groups. Hospitalization duration in the EVT group was 6 days shorter than that in the OS group, and total hospitalization cost was 0.88 million yen lower. Interaction analyses revealed that EVT and OS had no significant difference in terms of in-hospital death in patients with thromboembolic and atherothrombotic characteristics. Advanced age, decreased activities of daily living, chronic kidney disease, and old myocardial infarction were significant predictive factors for in-hospital mortality. Diabetes was a predictor of bowel resection after revascularization. CONCLUSIONS EVT was comparable to OS in terms of clinical outcomes in patients with acute superior mesenteric artery occlusion. Some predictive factors for mortality or bowel resection were obtained. REGISTRATION URL: www.umin.ac.jp/ctr/; Unique Identifier: UMIN000045240.
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Affiliation(s)
- Daiki Goto
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Kenji Yanishi
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Takaaki Ozawa
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Jun Yoshimura
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Hirofumi Kawamata
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Ayumu Fujioka
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Tomotsugu Seki
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Kan Zen
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science Kyoto Prefectural University of Medicine Kyoto Japan
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Okura T, Tanaka-Mizuno S, Ishii M, Takeuchi M, Kawakami K. Association Between Asian Dust Exposure and Pneumonia Hospitalization in Western Japan: A Case-Crossover Study. Asia Pac J Public Health 2024:10105395241260978. [PMID: 38880973 DOI: 10.1177/10105395241260978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Epidemiological studies have reported that Asian dust (AD), a type of desert dust, has harmful effects on human health. This study aimed to examine the association between AD exposure and hospitalization due to pneumonia. Data on patients in Western Japan admitted for pneumonia were included from a real-world database derived from electronic medical records. We used the meteorological observatory data of the most populous city in each prefecture, in which AD event was defined as a loss of visibility from a distance ≤10 km. A case-crossover design and conditional logistic regression model were used. Overall, 12 938 patients were included, and AD exposure events were observed for 557 days. Exposure to an AD event five days prior to hospitalization was significantly associated with hospitalization for pneumonia after adjusting for weather variables (odds ratio = 1.17; 95% confidence interval = [1.01, 1.36]). These findings suggest that AD exposure is associated with an increased rate of admission for pneumonia in Western Japan.
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Affiliation(s)
- Takayuki Okura
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
| | - Sachiko Tanaka-Mizuno
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
- Laboratory of Epidemiology and Prevention, Kobe Pharmaceutical University, Kobe, Japan
| | - Masanobu Ishii
- Department of Medical Information Science, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
| | - Masato Takeuchi
- Department of Public Health, Shizuoka Graduate University of Public Health, Shizuoka, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan
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3
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Lin W, Pan J, Li J, Zhou X, Liu X. Short-Term Exposure to Air Pollution and the Incidence and Mortality of Stroke: A Meta-Analysis. Neurologist 2024; 29:179-187. [PMID: 38048541 DOI: 10.1097/nrl.0000000000000544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
BACKGROUND The relationship between short-term exposure to various air pollutants [particulate matter <10 μm (PM 10 ), particulate matter <2.5 μm (PM 2.5 ), nitrogen dioxide (NO 2 ), sulfur dioxide (SO 2 ), carbon monoxide, and ozone (O 3 )] and the incidence and mortality of stroke remain unclear. REVIEW SUMMARY We conducted a comprehensive search across databases, including PubMed, Web of Science, and others. A random-effects model was employed to estimate the odds ratios (OR) and their 95% CIs. Short-term exposure to PM 10 , PM 2.5 , NO 2 , SO 2 , and O 3 was associated with increased stroke incidence [per 10 μg/m 3 increase in PM 2.5 : OR = 1.005 (95% CI: 1.004-1.007), per 10 μg/m 3 increase in PM 10 : OR = 1.006 (95% CI: 1.004-1.009), per 10 μg/m 3 increase in SO 2 : OR = 1.034 (95% CI: 1.020-1.048), per 10 μg/m 3 increase in NO 2 : OR = 1.029 (95% CI: 1.015-1.043), and O 3 for per 10 μg/m 3 increase: OR: 1.006 (95% CI: 1.004-1.007)]. In addition, short-term exposure to PM 2.5 , PM 10 , SO 2, and NO 2 was correlated with increased mortality from stroke [per 10 μg/m 3 increase in PM 2.5 : OR = 1.010 (95% CI: 1.006-1.013), per 10 μg/m 3 increase in PM 10 : OR = 1.004 (95% CI: 1.003-1.006), per 10 μg/m 3 increase in SO 2 : OR = 1.013 (95% CI: 1.007-1.019) and per 10 μg/m 3 increase in NO 2 : OR = 1.012 (95% CI: 1.008-1.015)]. CONCLUSION Reducing outdoor air pollutant levels may yield a favorable outcome in reducing the incidence and mortality associated with strokes.
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Affiliation(s)
- Wenjian Lin
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
- Tongji University School of Medicine, Shanghai, China
| | - Jie Pan
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Jiahe Li
- Tongji University School of Medicine, Shanghai, China
| | - Xiaoyu Zhou
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
| | - Xueyuan Liu
- Department of Neurology, Shanghai Tenth People's Hospital, Tongji University School of Medicine
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4
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Jiang Z, Zhang S, Gao T, Chen K, Liu Y, Liu Y, Wang T, Zeng P. Co-exposure to multiple air pollutants, genetic susceptibility, and the risk of myocardial infarction onset: a cohort analysis of the UK Biobank participants. Eur J Prev Cardiol 2024; 31:698-706. [PMID: 38085043 DOI: 10.1093/eurjpc/zwad384] [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: 10/05/2023] [Revised: 11/18/2023] [Accepted: 12/06/2023] [Indexed: 04/19/2024]
Abstract
AIMS The relationship between the long-term joint exposure to ambient air pollution and incidence of myocardial infarction (MI) and modification by genetic susceptibility remain inconclusive. METHODS AND RESULTS We analysed 329 189 UK Biobank participants without MI at baseline. Exposure concentrations to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and nitrogen oxides (NOx) were obtained. Air pollution score assessing the joint exposure was calculated, and its association with MI was evaluated via Cox model under the P value aggregation framework. Genetic susceptibility to MI was evaluated by incorporating polygenic risk score (PRS) into models. Risk prediction models were also established. During a median follow-up of 13.4 years, 9993 participants developed MI. Per interquartile range increase of PM2.5, PM10, NO2, and NOx resulted in 74% [95% confidence intervals (CIs) 69%-79%], 67% (63%-72%), 46% (42%-49%), and 38% (35%-41%) higher risk of MI. Compared with the lowest quartile (Q1) of air pollution score, the multivariable adjusted hazard ratio (HR) (95%CIs) of Q4 (the highest cumulative air pollution) was 3.50 (3.29-3.72) for MI. Participants with the highest PRS and air pollution score possessed the highest risk of incident MI (HR = 4.88, 95%CIs 4.35-5.47). Integrating PRS, air pollution exposure, and traditional factors substantially improved risk prediction of MI. CONCLUSION Long-term joint exposure to air pollutants including PM2.5, PM10, NO2, and NOx is substantially associated with increased risk of MI. Genetic susceptibility to MI strengthens such adverse joint association. Air pollutions together with genetic and traditional factors enhance the accuracy of MI risk prediction.
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Affiliation(s)
- Zhou Jiang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Shuo Zhang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Tongyu Gao
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Keying Chen
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Yuxin Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ying Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Key Laboratory of Environment and Health, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Xuzhou Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, 209 Tongshan Road, Yunlong District, Xuzhou, Jiangsu 221004, China
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5
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Hokimoto S, Kaikita K, Yasuda S, Tsujita K, Ishihara M, Matoba T, Matsuzawa Y, Mitsutake Y, Mitani Y, Murohara T, Noda T, Node K, Noguchi T, Suzuki H, Takahashi J, Tanabe Y, Tanaka A, Tanaka N, Teragawa H, Yasu T, Yoshimura M, Asaumi Y, Godo S, Ikenaga H, Imanaka T, Ishibashi K, Ishii M, Ishihara T, Matsuura Y, Miura H, Nakano Y, Ogawa T, Shiroto T, Soejima H, Takagi R, Tanaka A, Tanaka A, Taruya A, Tsuda E, Wakabayashi K, Yokoi K, Minamino T, Nakagawa Y, Sueda S, Shimokawa H, Ogawa H. JCS/CVIT/JCC 2023 guideline focused update on diagnosis and treatment of vasospastic angina (coronary spastic angina) and coronary microvascular dysfunction. J Cardiol 2023; 82:293-341. [PMID: 37597878 DOI: 10.1016/j.jjcc.2023.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/21/2023]
Affiliation(s)
| | - Koichi Kaikita
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan
| | - Masaharu Ishihara
- Department of Cardiovascular and Renal Medicine, School of Medicine, Hyogo Medical University, Japan
| | - Tetsuya Matoba
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Japan
| | - Yasushi Matsuzawa
- Division of Cardiology, Yokohama City University Medical Center, Japan
| | - Yoshiaki Mitsutake
- Division of Cardiovascular Medicine, Kurume University School of Medicine, Japan
| | - Yoshihide Mitani
- Department of Pediatrics, Mie University Graduate School of Medicine, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Japan
| | - Takashi Noda
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Koichi Node
- Department of Cardiovascular Medicine, Saga University, Japan
| | - Teruo Noguchi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Hiroshi Suzuki
- Division of Cardiology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Japan
| | - Jun Takahashi
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Yasuhiko Tanabe
- Department of Cardiology, Niigata Prefectural Shibata Hospital, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Wakayama Medical University, Japan
| | - Nobuhiro Tanaka
- Division of Cardiology, Tokyo Medical University Hachioji Medical Center, Japan
| | - Hiroki Teragawa
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Japan
| | - Takanori Yasu
- Department of Cardiovascular Medicine and Nephrology, Dokkyo Medical University Nikko Medical Center, Japan
| | - Michihiro Yoshimura
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Japan
| | - Yasuhide Asaumi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Shigeo Godo
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | - Hiroki Ikenaga
- Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences, Japan
| | - Takahiro Imanaka
- Department of Cardiovascular and Renal Medicine, School of Medicine, Hyogo Medical University, Japan
| | - Kohei Ishibashi
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Japan
| | | | - Yunosuke Matsuura
- Division of Cardiovascular Medicine and Nephrology, Department of Internal Medicine, Faculty of Medicine, University of Miyazaki, Japan
| | - Hiroyuki Miura
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan
| | - Yasuhiro Nakano
- Department of Cardiovascular Medicine, Kyushu University Graduate School of Medical Sciences, Japan
| | - Takayuki Ogawa
- Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, Japan
| | - Takashi Shiroto
- Department of Cardiovascular Medicine, Tohoku University Graduate School of Medicine, Japan
| | | | - Ryu Takagi
- Department of Cardiovascular Medicine, JR Hiroshima Hospital, Japan
| | - Akihito Tanaka
- Department of Cardiology, Nagoya University Graduate School of Medicine, Japan
| | - Atsushi Tanaka
- Department of Cardiovascular Medicine, Saga University, Japan
| | - Akira Taruya
- Department of Cardiovascular Medicine, Wakayama Medical University, Japan
| | - Etsuko Tsuda
- Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Japan
| | - Kohei Wakabayashi
- Division of Cardiology, Cardiovascular Center, Showa University Koto-Toyosu Hospital, Japan
| | - Kensuke Yokoi
- Department of Cardiovascular Medicine, Saga University, Japan
| | - Toru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Japan
| | - Yoshihisa Nakagawa
- Department of Cardiovascular Medicine, Shiga University of Medical Science, Japan
| | - Shozo Sueda
- Department of Cardiology, Pulmonology, Hypertension & Nephrology, Ehime University Graduate School of Medicine, Japan
| | - Hiroaki Shimokawa
- Graduate School, International University of Health and Welfare, Japan
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Nakai M, Iwanaga Y, Sumita Y, Miyamoto Y. Impact of seasonal variation on hospital admission and in-hospital mortality of acute cardiovascular diseases: a contemporary nationwide database study. Ann Epidemiol 2023; 85:100-107.e3. [PMID: 37209929 DOI: 10.1016/j.annepidem.2023.05.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/01/2023] [Accepted: 05/15/2023] [Indexed: 05/22/2023]
Abstract
PURPOSE Whether acute cardiovascular diseases (CVDs), such as acute heart failure (AHF), acute myocardial infarction (AMI), and acute aortic dissection (AAD), have distinct seasonal variations in the number of hospitalizations and in-hospital mortality was investigated using a nationwide database in Japan. METHODS The hospitalized patients with AHF, AMI, and AAD between April 2012 and March 2020 were identified. Multilevel mixed-effects logistic regression was conducted and adjusted odds ratio (aOR) was calculated. Also, the Poisson regression model was conducted to calculate the peak-to-trough ratio (PTTR) with peak month. RESULTS Patients identified were as follows: 752,434 AHF patients (median age, 82 years; male, 52.2%), 346,110 AMI patients (median age, 71 years; male, 72.2%), and 118,538 AAD patients (median age, 72 years; male, 58.0%). The monthly proportion of hospitalized patients was the highest in winter and the lowest in summer in all three diseases. Based on aOR, 14-day mortality was the lowest in spring for AHF, summer for AMI, and spring for AAD. Furthermore, the PTTRs with peak month were 1.24 for AHF in February, 1.34 for AMI in January, and 1.33 for AAD in February. CONCLUSIONS A clear seasonal pattern was observed in the number of hospitalizations and in-hospital mortality of all acute CVDs, independent of confounders.
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Affiliation(s)
- Michikazu Nakai
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan; Clinical Research Support Center, University of Miyazaki Hospital, Miyazaki, Japan
| | - Yoshitaka Iwanaga
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan; Department of Cardiology, Sakurabashi Watanabe Hospital, Osaka, Japan.
| | - Yoko Sumita
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshihiro Miyamoto
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
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7
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Wei Y, Fei L, Wang Y, Zhang M, Chen Z, Guo H, Ge S, Zhu S, Dong P, Yang K, Xie N, Zhao G. A time-series analysis of short-term ambient ozone exposure and hospitalizations from acute myocardial infarction in Henan, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:93242-93254. [PMID: 37507564 PMCID: PMC10447277 DOI: 10.1007/s11356-023-28456-2] [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: 03/15/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023]
Abstract
Epidemiological studies in recent years have identified an association between exposure to air pollutants and acute myocardial infarction (AMI); however, the association between short-term ozone (O3) exposure and AMI hospitalization remains unclear, particularly in developing countries. Therefore, this study collected information on 24,489 AMI patients, including daily air pollutant and meteorological data in Henan, China, between 2016 and 2021. A distributed lagged nonlinear model combined with a Poisson regression model was used to estimate the nonlinear lagged effect of O3 on AMI hospitalizations. We also quantified the effects of O3 on the number of AMI hospitalizations, hospitalization days, and hospitalization costs. The results showed that single- and dual-pollution models of O3 at lag0, lag1, and lag (01-07) were risk factors for AMI hospitalizations, with the most significant effect at lag03 (RR = 1.132, 95% CI:1.083-1.182). Further studies showed that males, younger people (15-64 years), warm seasons, and long sunshine duration were more susceptible to O3. Hospitalizations attributable to O3 during the study period accounted for 11.66% of the total hospitalizations, corresponding to 2856 patients, 33,492 hospital days, and 90 million RMB. Maintaining O3 at 10-130 µg/m3 can prevent hundreds of AMI hospitalizations and save millions of RMB per year in Henan, China. In conclusion, we found that short-term exposure to O3 was significantly associated with an increased risk of hospitalization for AMI in Henan, China, and that further reductions in ambient O3 levels may have substantial health and economic benefits for patients and local healthcare facilities.
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Affiliation(s)
- Yulong Wei
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Lin Fei
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Yongbin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
| | - Min Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xinxiang Medical University, Xinxiang, 453003, China
- School of Cardiovascular and Metabolic Medicine & Sciences, King's College London British Heart Foundation Centre of Research Excellence, London, SE5 9NU, UK
| | - Zhigang Chen
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Huige Guo
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Shiqi Ge
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Sen Zhu
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China
| | - Pingshuan Dong
- Department of Cardiology, The First Affiliated Hospital of Henan University of Science and Technology, Luoyang, 471003, China
| | - Kan Yang
- Department of Cardiovascular Surgery, Nanyang Affiliated Hospital of Zhengzhou University, Nanyang Central Hospital, Nanyang, 473009, China
| | - Na Xie
- The Cardiology Department of the Third Affiliated Hospital of Xinxiang Medical University, Xinxiang, 453003, China
| | - Guoan Zhao
- Department of Cardiology, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
- Life Science Research Center, The First Affiliated Hospital of Xinxiang Medical University, Weihui, 453100, China.
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8
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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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9
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Jin JQ, Lin GZ, Wu SY, Zheng MR, Liu H, Liu XY, Yan MQ, Chen ZY, Ou CQ. Short-term effects of individual exposure to PM 2.5 on hospital admissions for myocardial infarction and stroke: a population-based case-crossover study in Guangzhou, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023:10.1007/s11356-023-28058-y. [PMID: 37273056 DOI: 10.1007/s11356-023-28058-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 05/29/2023] [Indexed: 06/06/2023]
Abstract
Some studies have investigated the effects of PM2.5 on cardiovascular diseases based on the population-average exposure data from several monitoring stations. No one has explored the short-term effect of PM2.5 on cardiovascular hospitalizations using individual-level exposure data. We assessed the short-term effects of individual exposure to PM2.5 on hospitalizations for myocardial infarction (MI) and stroke in Guangzhou, China, during 2014-2019. The population-based data on cardio-cerebrovascular events were provided by Guangzhou Center for Disease Control and Prevention. Average annual percent changes (AAPCs) were used to describe trends in the hospitalization rates of MI and stroke. The conditional logistic regression model with a time-stratified case-crossover design was applied to estimate the effects of satellite-retrieved PM2.5 with 1-km resolution as individual-level exposure. Furthermore, we performed stratified analyses by demographic characteristics and season. There were 28,346 cases of MI, 188,611, and 36,850 cases of ischemic stroke (IS) and hemorrhagic stroke (HS), respectively, with an annual average hospitalization rate of 37.2, 247, and 48.4 per 100,000 people. Over the six-year study period, significant increasing trends in the hospitalization rates were observed with AAPCs of 12.3% (95% confidence interval [CI]: 7.24%, 17.6%), 13.1% (95% CI: 9.54%, 16.7%), and 9.57% (95% CI: 6.27%, 13.0%) for MI, IS, and HS, respectively. A 10 μg/m3 increase in PM2.5 was associated with an increase of 1.15% (95% CI: 0.308%, 1.99%) in MI hospitalization and 1.29% (95% CI: 0.882%, 1.70%) in IS hospitalization. A PM2.5-associated reduction of 1.17% (95% CI: 0.298%, 2.03%) was found for HS hospitalization. The impact of PM2.5 was greater in males than in females for MI hospitalization, and greater effects were observed in the elderly (≥ 65 years) and in cold seasons for IS hospitalization. Our study added important evidence on the adverse effect of PM2.5 based on satellite-retrieved individual-level exposure data.
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Affiliation(s)
- Jie-Qi Jin
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Guo-Zhen Lin
- Guangzhou Center for Disease Control and Prevention, 15, Guangzhou, 510440, China
| | - Shuang-Ying Wu
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Mu-Rui Zheng
- Guangzhou Center for Disease Control and Prevention, 15, Guangzhou, 510440, China
| | - Hui Liu
- Guangzhou Center for Disease Control and Prevention, 15, Guangzhou, 510440, China
| | - Xiang-Yi Liu
- Guangzhou Center for Disease Control and Prevention, 15, Guangzhou, 510440, China
| | - Min-Qian Yan
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Zhao-Yue Chen
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, 510515, China
| | - Chun-Quan Ou
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Department of Biostatistics, School of Public Health, Southern Medical University, Guangzhou, 510515, China.
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10
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Hasegawa K, Tsukahara T, Nomiyama T. Short-term associations of low-level fine particulate matter (PM 2.5) with cardiorespiratory hospitalizations in 139 Japanese cities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 258:114961. [PMID: 37137261 DOI: 10.1016/j.ecoenv.2023.114961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/09/2023] [Accepted: 04/24/2023] [Indexed: 05/05/2023]
Abstract
There have been few studies in non-western countries on the relationship between low levels of daily fine particulate matter (PM2.5) exposure and morbidity or mortality, and the impact of PM2.5 concentrations below 15 μg/m3, which is the latest World Health Organization Air Quality Guideline (WHO AQG) value for the 24-h mean, is not yet clear. We assessed the associations between low-level PM2.5 exposure and cardiorespiratory admissions in Japan. We collected the daily hospital admission count data, air pollutant data, and meteorological condition data recorded from April 2016 to March 2019 in 139 Japanese cities. City-specific estimates were obtained from conditional logistic regression models in a time-stratified case-crossover design and pooled by random-effect models. We estimated that every 10-μg/m3 increase in the concurrent-day PM2.5 concentration was related to a 0.52% increase in cardiovascular admissions (95% CI: 0.13-0.92%) and a 1.74% increase in respiratory admissions (95% CI: 1.41-2.07%). These values were nearly the same when the datasets were filtered to contain only daily PM2.5 concentrations <15 μg/m3. The exposure-response curves showed approximately sublinear-to-linear curves with no indication of thresholds. These associations with cardiovascular diseases weakened after adjusting for nitrogen dioxide or sulfur dioxide, but associations with respiratory diseases were almost unchanged when additionally adjusted for other pollutants. This study demonstrated that associations between daily PM2.5 and daily cardiorespiratory hospitalizations might persist at low concentrations, including those below the latest WHO AQG value. Our findings suggest that the updated guideline value may still be insufficient from the perspective of public health.
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Affiliation(s)
- Kohei Hasegawa
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan.
| | - Teruomi Tsukahara
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Department of Occupational Medicine, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
| | - Tetsuo Nomiyama
- Department of Preventive Medicine and Public Health, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan; Department of Occupational Medicine, School of Medicine, Shinshu University, 3-1-1 Asahi, Matsumoto, Nagano 390-8621, Japan
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11
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Ma X, Zhang B, Duan H, Wu H, Dong J, Guo X, Lu Z, Ma J, Xi B. Estimating future PM 2.5-attributed acute myocardial infarction incident cases under climate mitigation and population change scenarios in Shandong Province, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 256:114893. [PMID: 37059016 DOI: 10.1016/j.ecoenv.2023.114893] [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: 01/17/2023] [Revised: 04/07/2023] [Accepted: 04/08/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND The effects of fine particulate matter (PM2.5) on acute myocardial infarction (AMI) have been widely recognized. However, no studies have comprehensively evaluated future PM2.5-attributed AMI burdens under different climate mitigation and population change scenarios. We aimed to quantify the PM2.5-AMI association and estimate the future change in PM2.5-attributed AMI incident cases under six integrated scenarios in 2030 and 2060 in Shandong Province, China. METHODS Daily AMI incident cases and air pollutant data were collected from 136 districts/counties in Shandong Province from 2017 - 2019. A two-stage analysis with a distributed lag nonlinear model was conducted to quantify the baseline PM2.5-AMI association. The future change in PM2.5-attributed AMI incident cases was estimated by combining the fitted PM2.5-AMI association with the projected daily PM2.5 concentrations under six integrated scenarios. We further analyzed the factors driving changes in PM2.5-related AMI incidence using a decomposition method. RESULTS Each 10 μg/m3 increase in PM2.5 exposure at lag05 was related to an excess risk of 1.3 % (95 % confidence intervals: 0.9 %, 1.7 %) for AMI incidence from 2017 - 2019 in Shandong Province. The estimated total PM2.5-attributed AMI incident cases would increase by 10.9-125.9 % and 6.4-244.6 % under Scenarios 1 - 3 in 2030 and 2060, whereas they would decrease by 0.9-5.2 % and 33.0-46.2 % under Scenarios 5 - 6 in 2030 and 2060, respectively. Furthermore, the percentage increases in PM2.5-attributed female cases (2030: -0.3 % to 135.1 %; 2060: -33.2 % to 321.5 %) and aging cases (2030: 15.2-171.8 %; 2060: -21.5 % to 394.2 %) would wholly exceed those in male cases (2030: -1.8 % to 133.2 %; 2060: -41.1 % to 264.3 %) and non-aging cases (2030: -41.0 % to 45.7 %; 2060: -89.5 % to -17.0 %) under six scenarios in 2030 and 2060. Population aging is the main driver of increased PM2.5-related AMI incidence under Scenarios 1 - 3 in 2030 and 2060, while improved air quality can offset these negative effects of population aging under the implementation of the carbon neutrality and 1.5 °C targets. CONCLUSION The combination of ambitious climate policies (i.e., 1.5 °C warming limits and carbon neutrality targets) with stringent clean air policies is necessary to reduce the health impacts of air pollution in Shandong Province, China, regardless of population aging.
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Affiliation(s)
- Xiaoyun Ma
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Bingyin Zhang
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Haiping Duan
- Qingdao Municipal Center for Disease Control and Prevention, Qingdao, Shandong, China
| | - Han Wu
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Jing Dong
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Xiaolei Guo
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Zilong Lu
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China
| | - Jixiang Ma
- Shandong Center for Disease Control and Prevention, and Academy of Preventive Medicine, Shandong University, Jinan, Shandong, China.
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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12
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Jia R, Wei M, Lei J, Meng X, Du R, Yang M, Lu X, Jiang Y, Cao R, Wang L, Song L. PM 2.5 induce myocardial injury in hyperlipidemic mice through ROS-pyroptosis signaling pathway. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 254:114699. [PMID: 36889212 DOI: 10.1016/j.ecoenv.2023.114699] [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: 10/08/2022] [Revised: 02/07/2023] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
Exposure to particulate matters with diameters below 2.5 µm (PM2.5) is considered a major risk factor for cardiovascular diseases (CVDs). The closest associations between PM2.5 and CVDs have been observed in hyperbetalipoproteinemia cases, although the detailed underpinning mechanism remains undefined. In this work, hyperlipidemic mice and H9C2 cells were used to examine the effects of PM2.5 on myocardial injury and their underlying mechanisms. The results revealed that PM2.5 exposure caused severe myocardial damage in the high-fat mouse model. Oxidative stress and pyroptosis were also observed along with myocardial injury. After inhibiting pyroptosis with disulfiram (DSF), the level of pyroptosis was effectively reduced as well as myocardial injury, suggesting that PM2.5 induced the pyroptosis pathway and further caused myocardial injury and cell death. Afterwards, by suppressing PM2.5-induced oxidative stress with N-acetyl-L-cysteine (NAC), myocardial injury was markedly ameliorated, and the upregulation of pyroptosis markers was reversed, which indicated that PM2.5-pyroptosis was also improved. Taken together, this study revealed that PM2.5 induce myocardial injury through the ROS-pyroptosis signaling pathway in hyperlipidemia mice models, providing a potential approach for clinical interventions.
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Affiliation(s)
- Ruxue Jia
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China; Department of Cardiology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Min Wei
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China
| | - Jinrong Lei
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China
| | - Xianzong Meng
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China; Department of Cognitive Neuroscience, Centre for Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Rui Du
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China
| | - Mengxin Yang
- Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Xinjun Lu
- First Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116000, People's Republic of China
| | - Yizhu Jiang
- Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Ran Cao
- Second Affiliated Hospital, Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China
| | - Lili Wang
- Department of Cardiology, Second Affiliated Hospital of Dalian Medical University, Dalian, Liaoning Province 116023, People's Republic of China.
| | - Laiyu Song
- College of Medical Laboratory, Dalian Medical University, Dalian, Liaoning Province 116044, People's Republic of China.
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13
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Tonegawa-Kuji R, Kanaoka K, Iwanaga Y. Current status of real-world big data research in the cardiovascular field in Japan. J Cardiol 2023; 81:307-315. [PMID: 36126909 DOI: 10.1016/j.jjcc.2022.09.006] [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: 08/30/2022] [Accepted: 09/02/2022] [Indexed: 02/01/2023]
Abstract
Real-world data (RWD) are observational data obtained by collecting, structuring, and accumulating patient information among the medical big data. RWD are derived from a variety of patient medical care and health information outside of conventional research data, and include electronic health records, claims data, registry data of disease, drug and device, health check-up data, and more recently, patient information data from wearable devices. They are currently being utilized in various forms for optimal medical care and real-world evidence (RWE) is constructed through a process of hypothesis generation and verification based on the RWD research. Together with classic clinical research and pragmatic trials, RWE shapes the learning healthcare system and contributes to the improvement of medical care. In the cardiovascular medical care of the current super-aged society, the need for a variety of RWE and the research is increasing, since the guidelines established over time and the medical care based on it cannot necessarily be the best in accordance with the current medical situation. In this review, we focus on the RWD and RWE studies in the cardiovascular medical field and outlines their current status in Japan. Furthermore, we discuss the potential for extending the studies and issues related to the use of medical big data and RWD.
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Affiliation(s)
- Reina Tonegawa-Kuji
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Koshiro Kanaoka
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Yoshitaka Iwanaga
- Department of Medical and Health Information Management, National Cerebral and Cardiovascular Center, Suita, Japan.
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14
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Halasz G, Bandera F, Piepoli M. Editorial comments: focus on cardiovascular diseases. Eur J Prev Cardiol 2023; 30:203-205. [PMID: 36729046 DOI: 10.1093/eurjpc/zwad016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Geza Halasz
- Azienda Ospedaliera San Camillo-Forlanini, Circonvallazione Gianicolense, Rome, Italy
| | - Francesco Bandera
- Clinical Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
- Department of Biomedical Science for Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
| | - Massimo Piepoli
- Clinical Cardiology, IRCCS Policlinico San Donato, Via Morandi 30, 20097 San Donato Milanese, Milan, Italy
- Department of Biomedical Science for Health, University of Milan, Via Festa del Perdono 7, 20122 Milan, Italy
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15
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Tsaban G, Peles I, Barrett O, Abramowitz Y, Shmueli H, Alnsasra H, Cafri C, Zahger D, Koifman E. Nonobstructive coronary atherosclerosis is associated with adverse prognosis among patients diagnosed with myocardial infarction without obstructive coronary arteries. Atherosclerosis 2023; 366:8-13. [PMID: 36652749 DOI: 10.1016/j.atherosclerosis.2023.01.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 12/10/2022] [Accepted: 01/11/2023] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIMS The prognostic impact of nonobstructive coronary artery disease (CAD), as opposed to normal coronary arteries, on long-term outcomes of patients with myocardial infarction with no obstructive coronary arteries (MINOCA) is unclear. We aimed to address the association between nonobstructive-CAD and major adverse events (MAE) following MINOCA. METHODS We conducted a retrospective cohort study of consecutive MINOCA patients admitted to a large referral medical center between 2005 and 2018. Patients were classified according to coronary angiography as having either normal-coronaries or nonobstructive-CAD. The primary outcome was MAE, defined as the composite of all-cause mortality and recurrent acute coronary syndrome (ACS). RESULTS Of the 1544 MINOCA patients, 651 (42%) had normal coronaries, and 893 (58%) had CAD. The mean age was 61.2 ± 12.6 years, and 710 (46%) were females. Nonobstructive-CAD patients were older and less likely to be females, with higher rates of diabetes, hypertension, dyslipidemia, atrial fibrillation, and chronic renal-failure (p < 0.05). At a median follow-up of 7 years, MAE occurred in 203 (23%) patients and 67 (10%) patients in the nonobstructive-CAD and normal-coronaries groups, respectively (p < 0.01). In multivariable models, nonobstructive -CAD was significantly associated with long-term MAE [adjusted-hazard-ratio (aHR):1.67, 95% confidence-interval (95%CI):1.25-2.23; p < 0.001]. Other factors associated with a higher MAE-risk were older-age (aHR:1.05,95%CI:1.03-1.06; p < 0.001) and left ventricular ejection-fraction<40% (aHR:3.04,95%CI:2.03-4.57; p < 0.001), while female-sex (aHR:0.72, 95%CI: 0.56-0.94; p=0.014) and sinus rhythm at presentation (aHR:0.66, 95%CI: 0.44-0.98; p=0.041) were associated with lower MAE-risk. CONCLUSIONS In MINOCA, nonobstructive-CAD is independently associated with a higher MAE-risk than normal-coronaries. This finding may promote risk-stratification of patients with nonobstructive-CAD-MINOCA who require tighter medical follow-up and treatment optimization.
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Affiliation(s)
- Gal Tsaban
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Department of Cardiology, Soroka University Medical Center, Beersheba, Israel.
| | - Ido Peles
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Clinical Research Center, Soroka University Medical Center, Beersheba, Israel
| | - Orit Barrett
- Department of Cardiology, Soroka University Medical Center, Beersheba, Israel; Clinical Research Center, Soroka University Medical Center, Beersheba, Israel
| | - Yigal Abramowitz
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Department of Cardiology, Soroka University Medical Center, Beersheba, Israel
| | - Hezzy Shmueli
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Department of Cardiology, Soroka University Medical Center, Beersheba, Israel
| | - Hilmi Alnsasra
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Department of Cardiology, Soroka University Medical Center, Beersheba, Israel
| | - Carlos Cafri
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Department of Cardiology, Soroka University Medical Center, Beersheba, Israel
| | - Doron Zahger
- Faculty of Health Sciences, Ben Gurion University of the Negev, Beersheba, Israel; Department of Cardiology, Soroka University Medical Center, Beersheba, Israel
| | - Edward Koifman
- Department of Cardiology, Meir Medical Center, Kfar Saba, Israel
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16
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Huang QS, Zhou LX, Yang LL, Jiang YX, Xiao H, Li DW, Zhou YM, Hu YG, Li N, Li YF, Ji AL, Luo P, Cai TJ. Association between ambient carbon monoxide levels and hospitalization costs of patients with myocardial infarction: Potential effect modification by ABO blood group. ENVIRONMENTAL RESEARCH 2023; 216:114516. [PMID: 36220442 DOI: 10.1016/j.envres.2022.114516] [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: 06/24/2022] [Revised: 09/29/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
Previous researches have reported the association between air pollution and various diseases. However, few researches have investigated whether air pollutants are associated with the economic loss resulting from patients' hospitalization, especially the economic loss of hospitalization due to acute cardiovascular events. The purpose of our research was to explore the association between the levels of carbon monoxide (CO), taken as an index of pollution, and the hospitalization costs of myocardial infarction (MI), and the potential effect modification by the ABO blood group. A total of 3237 MI inpatients were included in this study. A multiple linear regression model was used to evaluate the association between ambient CO levels and hospitalization costs of MI patients. Moreover, we performed stratified analyses by age, gender, body mass index (BMI), season, hypertension, and ABO blood types. There was a positive association between the levels of CO in the air and the costs of hospitalization caused by MI. Furthermore, such association was stronger in males, BMI ≥25, <65 years, with hypertension, and non-O blood group. Interestingly, we found the association was particularly significant in patients with blood group B. Overall, our study first found that ambient CO levels could have an impact on the hospitalization costs for MI patients, and those with blood group B can be more sensitive.
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Affiliation(s)
- Qing-Song Huang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Lai-Xin Zhou
- Medical Department, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Li-Li Yang
- Department of Information, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, 400037, China
| | - Yue-Xu Jiang
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Da-Wei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yu-Meng Zhou
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Yue-Gu Hu
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Na Li
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ya-Fei Li
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China
| | - Ai-Ling Ji
- Department of Preventive Medicine, Chongqing Medical and Pharmaceutical College, Chongqing, 401331, China
| | - Peng Luo
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China.
| | - Tong-Jian Cai
- School of Public Health, The Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, 550025, China; Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, China.
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17
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Ong GJ, Sellers A, Mahadavan G, Nguyen TH, Worthley MI, Chew DP, Horowitz JD. 'Bushfire Season' in Australia: Determinants of Increases in Risk of Acute Coronary Syndromes and Takotsubo Syndrome. Am J Med 2023; 136:88-95. [PMID: 36058309 DOI: 10.1016/j.amjmed.2022.08.013] [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: 08/04/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Climate change has resulted in an increase in ambient temperatures during the summer months as well as an increase in risk of associated air pollution and of potentially disastrous bushfires throughout much of the world. The increasingly frequent combination of elevated summer temperatures and bushfires may be associated with acute increases in risks of cardiovascular events, but this relationship remains unstudied. We evaluated the individual and cumulative impacts of daily fluctuations in temperature, fine particulate matter of less than 2.5 µm (PM2.5) pollution and presence of bushfires on incidence of acute coronary syndromes and Takotsubo syndrome. METHODS From November 1, 2019, to February 28, 2020, all admissions with acute coronary syndromes or Takotsubo syndrome to South Australian tertiary public hospitals were evaluated. Univariate and combined associations were sought among each of 1) maximal daily temperature, 2) PM2.5 concentrations, and 3) presence of active bushfires within 200 km of the hospitals concerned. RESULTS A total of 504 patients with acute coronary syndromes and 35 with Takotsubo syndrome were studied. In isolation, increasing temperature was associated (rs = 0.26, P = .005) with increased incidence of acute coronary syndromes, while there were similar, but nonsignificant correlations for PM2.5 and presence of bushfires. Combinations of all these risk factors were also associated with a doubling of risk of acute coronary syndromes. No significant associations were found for Takotsubo syndrome. CONCLUSION The combination of high temperatures, presence of bushfires and associated elevation of atmospheric PM2.5 concentrations represents a substantially increased risk for precipitation of acute coronary syndromes; this risk should be factored into health care planning including public education and acute hospital preparedness.
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Affiliation(s)
- Gao Jing Ong
- Cardiology Research Laboratory, Basil Hetzel Institute for Translational Health Research, Queen Elizabeth Hospital, Adelaide, Australia; University of Adelaide, Adelaide, Australia; Cardiology Department, Central Adelaide Local Health Network, Adelaide, Australia
| | - Alexander Sellers
- Cardiology Department, Central Adelaide Local Health Network, Adelaide, Australia
| | - Gnanadevan Mahadavan
- Cardiology Department, Central Adelaide Local Health Network, Adelaide, Australia; Cardiology Department, Northern Adelaide Local Health Network, Elizabeth Vale, Adelaide, Australia
| | - Thanh H Nguyen
- Cardiology Research Laboratory, Basil Hetzel Institute for Translational Health Research, Queen Elizabeth Hospital, Adelaide, Australia; University of Adelaide, Adelaide, Australia
| | - Matthew I Worthley
- University of Adelaide, Adelaide, Australia; Cardiology Department, Central Adelaide Local Health Network, Adelaide, Australia
| | - Derek P Chew
- South Australian Health and Medical Research Institute, Adelaide, Australia; College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - John D Horowitz
- Cardiology Research Laboratory, Basil Hetzel Institute for Translational Health Research, Queen Elizabeth Hospital, Adelaide, Australia; University of Adelaide, Adelaide, Australia.
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18
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Li Z, Liu M, Wu Z, Liu Y, Li W, Liu M, Lv S, Yu S, Jiang Y, Gao B, Wang X, Li X, Wang W, Lin H, Guo X, Liu X. Association between ambient air pollution and hospital admissions, length of hospital stay and hospital cost for patients with cardiovascular diseases and comorbid diabetes mellitus: Base on 1,969,755 cases in Beijing, China, 2014-2019. ENVIRONMENT INTERNATIONAL 2022; 165:107301. [PMID: 35598418 DOI: 10.1016/j.envint.2022.107301] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 05/10/2022] [Accepted: 05/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Evidence on the effects of the air pollutants on the hospital admissions, hospital cost and length of stay (LOS) among patients with comorbidities remains limited in China, particularly for patients with cardiovascular diseases and comorbid diabetes mellitus (CVD-DM). METHODS We collected daily data on CVD-DM patients from 242 hospitals in Beijing between 2014 and 2019. Generalized additive model was employed to quantify the associations between admissions, LOS, and hospital cost for CVD-DM patients and air pollutants. We further evaluated the attributable risk posed by air pollutants to CVD-DM patients, using both Chinese and WHO air quality guidelines as reference. RESULTS Per 10 ug/m3 increase of particles with an aerodynamic diameter < 2.5 μm (PM2.5), particles with an aerodynamic diameter < 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbonic oxide (CO) and ozone (O3) corresponded to a 0.64% (95% CI: 0.57 to 0.71), 0.52% (95% CI: 0.46 to 0.57), 0.93% (95% CI: 0.67 to 1.20), 0.98% (95% CI: 0.81 to 1.16), 1.66% (95% CI: 1.18 to 2.14) and 0.53% (95% CI: 0.45 to 0.61) increment for CVD-DM patients' admissions. Among the six pollutants, particulate pollutants (PM2.5 and PM10) in most lag days exhibited adverse effects on LOS and hospital cost. For every 10 ug/m3 increase in PM2.5 and PM10, the absolute increase with LOS will increase 62.08 days (95% CI: 28.93 to 95.23) and 51.77 days (95% CI:22.88 to 80.66), respectively. The absolute increase with hospital cost will increase 105.04 Chinese Yuan (CNY) (95% CI: 49.27 to 160.81) and 81.76 CNY (95% CI: 42.01 to 121.51) in PM2.5 and PM10, respectively. Given WHO 2021 air quality guideline as the reference, PM2.5 had the maximum attributable fraction of 3.34% (95% CI: 2.94% to 3.75%), corresponding to an avoidable of 65,845 (95% CI: 57,953 to 73,812) patients with CVD-DM. CONCLUSION PM2.5 and PM10 are positively associated with hospital admissions, hospital cost and LOS for patients with CVD-DM. Policy changes to reduce air pollutants exposure may reduce CVD-DM admissions and substantial savings in health care spending and LOS.
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Affiliation(s)
- Zhiwei Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Mengyang Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China; Department of Nutrition and Food Hygiene, School of Public Health, Hebei Medical University, Shijiazhuang, China
| | - Zhiyuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yue Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Weiming Li
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Mengmeng Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Shiyun Lv
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Siqi Yu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Yanshuang Jiang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China
| | - Bo Gao
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China
| | - Xia Li
- Department of Mathematics and Statistics, La Trobe University, Melbourne 3086, Australia
| | - Wei Wang
- School of Medical Sciences and Health, Edith Cowan University, WA6027 Perth, Australia
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-Sen University, Guangzhou, Guangdong, China.
| | - Xiuhua Guo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China; School of Medical Sciences and Health, Edith Cowan University, WA6027 Perth, Australia; National Institute for Data Science in Health and Medicine, Capital Medical University, China.
| | - Xiangtong Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
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19
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Ishii M, Tsujita K, Okamoto H, Koto S, Nishi T, Nakai M, Sumita Y, Iwanaga Y, Azuma N, Matoba S, Hirata KI, Hikichi Y, Yokoi H, Ikari Y, Uemura S. Resources for cardiovascular healthcare associated with 30-day mortality in acute myocardial infarction with cardiogenic shock. EUROPEAN HEART JOURNAL OPEN 2022; 2:oeab047. [PMID: 35919660 PMCID: PMC9242083 DOI: 10.1093/ehjopen/oeab047] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 12/09/2021] [Accepted: 12/29/2021] [Indexed: 01/13/2023]
Abstract
Aims Although primary percutaneous coronary intervention (PCI) and mechanical circulatory support (MCS), such as extracorporeal membrane oxygenation (ECMO) or intra-aortic balloon pumping (IABP), have been widely used for acute myocardial infarction (AMI) patients with cardiogenic shock (AMICS), their in-hospital mortality remains high. This study aimed to investigate the association of cardiovascular healthcare resources with 30-day mortality in AMICS. Methods and results This was an observational study using a Japanese nationwide administrative data (JROAD-DPC) of 260 543 AMI patients between April 2012 and March 2018. Of these, 45 836 AMICS patients were divided into three categories based on MCS use: with MCS (ECMO with/without IABP), IABP only, or without MCS. Certified hospital density and number of board-certified cardiologists were used as a metric of cardiovascular healthcare resources. We estimated the association of MCS use, cardiovascular healthcare resources, and 30-day mortality. The 30-day mortality was 71.2% for the MCS, 23.9% for IABP only, and 37.8% for the group without MCS. The propensity score-matched and inverse probability-weighted Cox frailty models showed that primary PCI was associated with a low risk for mortality. Higher hospital density and larger number of cardiologists in the responsible hospitals were associated with a lower risk for mortality. Conclusion Although the 30-day mortality remained extremely high in AMICS, indication of primary PCI and improvement in providing cardiovascular healthcare resources associated with the short-term prognosis of AMICS.
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Affiliation(s)
- Masanobu Ishii
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Kenichi Tsujita
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1, Honjo, Chuo-ku, Kumamoto 860-8556, Japan
| | - Hiroshi Okamoto
- Cardiovascular Medicine, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Satoshi Koto
- Cardiovascular Medicine, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Takeshi Nishi
- Cardiovascular Medicine, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan
| | - Michikazu Nakai
- National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Yoko Sumita
- National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Yoshitaka Iwanaga
- National Cerebral and Cardiovascular Center, 6-1 Kishibe-Shimmachi, Suita, Osaka 564-8565, Japan
| | - Nobuyoshi Azuma
- Department of Vascular Surgery, Asahikawa Medical University, 2-1-1-1, Midorigaoka higashi, Asahikawa, Hokkaido 078-8510, Japan
| | - Satoaki Matoba
- Department of Cardiovascular Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kawaramachi-Hirokoji, Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan
| | - Ken-Ichi Hirata
- Division of Cardiovascular Medicine, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1 Kusunoki-chou, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Yutaka Hikichi
- Department of Cardiology, Saga-Ken Medical Centre Koseikan, 400 Kasemachinakabaru, Saga-shi, Saka Japan
| | - Hiroyoshi Yokoi
- Cardiovascular Center, Fukuoka Sanno Hospital, 3-6-45, Momochihama, Sawara-ku, Fukuoka 814-0001, Japan
| | - Yuji Ikari
- Department of Cardiovascular Medicine, Tokai University School of Medicine, 143 Shimokasuya, Isehara-shi, Kanagawa 259-1193, Japan
| | - Shiro Uemura
- Cardiovascular Medicine, Kawasaki Medical School, 577, Matsushima, Kurashiki, Okayama 701-0192, Japan
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20
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Halasz G, Parati G, Piepoli MF. Editor comment: Focus on arterial hypertension and coronary artery disease. Eur J Prev Cardiol 2021; 28:1411-1414. [PMID: 34626191 DOI: 10.1093/eurjpc/zwab163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/15/2021] [Indexed: 11/14/2022]
Affiliation(s)
- Geza Halasz
- Cardiac Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Parma, Italy
| | - Gianfranco Parati
- University of Milano-Bicocca and IRCCS, Istituto Auxologico Italiano, Milan, Italy
| | - Massimo F Piepoli
- Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
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21
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Stafoggia M, Renzi M, Forastiere F, Ljungman P, Davoli M, De' Donato F, Gariazzo C, Michelozzi P, Scortichini M, Solimini A, Viegi G, Bellander T. Short-term effects of particulate matter on cardiovascular morbidity in Italy: a national analysis. Eur J Prev Cardiol 2020; 29:1202-1211. [PMID: 33913491 DOI: 10.1093/eurjpc/zwaa084] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/25/2020] [Accepted: 09/10/2020] [Indexed: 01/03/2023]
Abstract
AIMS We aimed at investigating the relationship between particulate matter (PM) and daily admissions for cardiovascular diseases (CVDs) at national level in Italy. METHODS AND RESULTS Daily numbers of cardiovascular hospitalizations were collected for all 8084 municipalities of Italy, in the period 2013-2015. A satellite-based spatiotemporal model was used to estimate daily PM10 (inhalable particles) and PM2.5 (fine particles) concentrations at 1-km2 resolution. Multivariate Poisson regression models were fit to estimate the association between daily PM and cardiovascular admissions. Flexible functions were estimated to explore the shape of the associations at low PM concentrations, also in non-urban areas. We analysed 2 154 810 acute hospitalizations for CVDs (25% stroke, 24% ischaemic heart diseases, 22% heart failure, and 5% atrial fibrillation). Relative increases of total cardiovascular admissions, per 10 µg/m3 variation in PM10 and PM2.5 at lag 0-5 (average of last 6 days since admission), were 0.55% (95% confidence intervals: 0.32%, 0.77%) and 0.97% (0.67%, 1.27%), respectively. The corresponding estimates for heart failure were 1.70% (1.28%, 2.13%) and 2.66% (2.09%, 3.23%). We estimated significant effects of PM10 and PM2.5 also on ischaemic heart diseases, myocardial infarction, atrial fibrillation, and ischaemic stroke. Associations were similar between less and more urbanized areas, and persisted even at low concentrations, e.g. below WHO guidelines. CONCLUSION PM was robustly associated with peaks in daily cardiovascular admissions, especially for heart failure, both in large cities and in less urbanized areas of Italy. Current WHO Air Quality Guidelines for PM10 and PM2.5 are not sufficient to protect public health.
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Affiliation(s)
- Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service-ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy.,Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77 Stockholm, Sweden
| | - Matteo Renzi
- Department of Epidemiology, Lazio Region Health Service-ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Francesco Forastiere
- Institute for Research and Biomedical Innovation, National Research Council, Via Ugo la Malfa 153, 90146 Palermo, Italy.,Environmental Research Group, King's College, 150 Stamford Street, SE1 9NH London, UK
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77 Stockholm, Sweden.,Department of Cardiology, Danderyds Hospital, Entrévägen 2, 182 57 Danderyd, Sweden
| | - Marina Davoli
- Department of Epidemiology, Lazio Region Health Service-ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Francesca De' Donato
- Department of Epidemiology, Lazio Region Health Service-ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Claudio Gariazzo
- Occupational and Environmental Medicine, Epidemiology and Hygiene Department, Italian Workers' Compensation Authority (INAIL), Via di Fontana Candida, 1, 00078 Monte Porzio Catone, Italy
| | - Paola Michelozzi
- Department of Epidemiology, Lazio Region Health Service-ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Matteo Scortichini
- Department of Epidemiology, Lazio Region Health Service-ASL Roma 1, Via C. Colombo 112, 00147 Rome, Italy
| | - Angelo Solimini
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Piazzale Aldo Moro 5, 00185 Rome, Italy
| | - Giovanni Viegi
- Institute for Research and Biomedical Innovation, National Research Council, Via Ugo la Malfa 153, 90146 Palermo, Italy.,Institute of Clinical Physiology, National Research Council, Via Giuseppe Moruzzi 1, 56124 Pisa, Italy
| | - Tom Bellander
- Institute of Environmental Medicine, Karolinska Institutet, PO Box 210, SE-171 77 Stockholm, Sweden.,Center for Occupational and Environmental Medicine, Stockholm Region, Solnavägen 4 plan 10, 113 65 Stockholm, Sweden
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22
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Abstract
Air pollutants pose a serious worldwide health hazard, causing respiratory and cardiovascular morbidity and mortality. Pollutants perturb the autonomic nervous system, whose function is critical to cardiopulmonary homeostasis. Recent studies suggest that pollutants can stimulate defensive sensory nerves within the cardiopulmonary system, thus providing a possible mechanism for pollutant-induced autonomic dysfunction. A better understanding of the mechanisms involved would likely improve the management and treatment of pollution-related disease.
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Affiliation(s)
- Thomas E Taylor-Clark
- Molecular Pharmacology and Physiology, Morsani College of Medicine, University of South Florida, Tampa, Florida
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23
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Erkens R, Kelm M. Fine particulate matter: An underestimated cardiovascular risk factor? Eur J Prev Cardiol 2020; 28:e9-e10. [PMID: 33611425 DOI: 10.1177/2047487319899122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ralf Erkens
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.,CARID, Cardiovascular Research Institute Duesseldorf, Medical Faculty, University Duesseldorf, Duesseldorf, Germany
| | - Malte Kelm
- Division of Cardiology, Pulmonology and Vascular Medicine, Medical Faculty, University Duesseldorf, Duesseldorf, Germany.,CARID, Cardiovascular Research Institute Duesseldorf, Medical Faculty, University Duesseldorf, Duesseldorf, Germany
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