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La contaminación atmosférica por partículas como factor de riesgo para la depresión del segmento ST en pacientes con
Kai Jen Chuang1, Brent A Coull, Antonella Zanobetti
1Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard School of Public Health, Boston, MA 02215, USA.
Circulation
|September 10, 2008
Resumen
La exposición a partículas finas (PM2.5) y a los contaminantes atmosféricos del carbón negro está relacionada con la depresión del segmento ST en pacientes cardíacos. Este riesgo es mayor en individuos con lesiones recientes del miocardio, particularmente dentro del primer mes después del evento.
Área de la Ciencia:
- Salud Ambiental Salud del medio ambiente.
- Cardiología Cardiología.
- Epidemiología La epidemiología.
Sus antecedentes:
- La exposición a partículas en suspensión (PM) es un factor de riesgo conocido para la enfermedad cardiovascular.
- La isquemia inducida por PM es un mecanismo sospechoso que vincula la contaminación con eventos cardíacos adversos.
Objetivo del estudio:
- Investigar la asociación entre la contaminación del aire ambiente y los cambios en el segmento ST en pacientes cardíacos.
- Identificar contaminantes específicos y subgrupos de pacientes con mayor riesgo.
Principales métodos:
- Un estudio de medidas repetidas que involucró a 48 pacientes cardíacos monitoreados durante hasta 1 año.
- El monitoreo de 24 horas de Holter ECG midió los niveles del segmento ST, correlacionados con los niveles ambientales de PM2.5 y carbono negro.
- El análisis incluyó a pacientes con infarto de miocardio, síndrome coronario agudo o enfermedad arterial coronaria estable.
Principales resultados:
- Los niveles elevados de partículas finas (PM2.5) y de carbono negro predijeron la depresión del segmento ST.
- Se encontró una asociación significativa entre el aumento de la exposición al carbono negro y la depresión del segmento ST.
- Los efectos fueron más pronunciados en pacientes con infarto de miocardio reciente o diabetes, y dentro del primer mes después de la hospitalización.
Conclusiones:
- La depresión del segmento ST en pacientes cardíacos está asociada con la exposición a PM2.5 y carbono negro.
- El riesgo de depresión del segmento ST relacionada con la contaminación es elevado en pacientes con lesiones recientes del miocardio, especialmente en el primer mes después de un evento cardíaco.
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