在接受皮肤冠状动脉干预的患者中,颗粒物空气污染和长期结果
Issam Motairek1, Salil V Deo2,3, Yakov Elgudin2,3
1Harrington Heart and Vascular Institute, University Hospitals, Cleveland, Ohio, USA.
长期暴露于细颗粒物 (PM2.5) 空气污染增加了主要不良心血管事件 (MACE) 的风险,并减少了经过皮肤冠状动脉干预 (PCI) 的退伍军人的寿命. 即使是较低的PM2.5水平也会给健康带来重大风险,强调需要改善空气质量.
科学领域:
- 心血管医学 心血管医学
- 环境健康 环境健康
- 公共卫生 公共卫生
背景情况:
- 众所周知,细颗粒物 (PM2.5) 会推进动脉样硬化,增加斑块的脆弱性.
- 患有大量动脉样硬化负担的人面临空气污染暴露的风险增加.
研究的目的:
- 调查环境PM2.5持续暴露与皮肤穿透冠状动脉干预 (PCI) 后不良健康结果之间的关联.
主要方法:
- 分析了2005-2018年间接受选用PCI的美国退伍军人的临床和程序数据.
- 年度环境PM2.5暴露水平与主要不良心血管事件 (MACE) 相相关,使用时间变化的Cox回归.
- 灵活的参数模型评估了PM2.5暴露对15年的预期寿命的影响.
主要成果:
- 这项研究包括73,425名退伍军人,年平均PM2.5暴露量为8.4±1.8μg/m3.
- 在PCI后5年,10年和15年,MACE的发病率分别达到28%,48%和65%.
- 每增加1μg/m3的PM2.5与MACE的8.7%的增加有关,10μg/m3的暴露导致15年内失去了1.1至7.6个月的生命.
结论:
- 接受选择性PCI的退伍军人面临着由于长期暴露于PM2.5的MACE风险增加和寿命缩短,即使在美国的环境水平上也是如此.
- 这些发现强调了加强空气质量标准和针对患者的干预措施的必要性.
- 弱势群体需要更好地保护他们免受空气污染的不利影响.
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