Association of Long-Term Exposure to Ambient Fine Particulate Matter with Atherosclerotic Cardiovascular Disease Incidence Varies across Populations with Different Predicted Risks: The China-PAR Project

危险系数 医学 比例危险模型 置信区间 入射(几何) 绝对风险降低 人口 动脉粥样硬化性心血管疾病 微粒 内科学 风险评估 相对风险 人口学 心血管健康 环境卫生 疾病 化学 数学 几何学 有机化学 计算机安全 社会学 计算机科学
作者
Chenxi Yuan,Fangchao Liu,Keyong Huang,Chong Shen,Jianxin Li,Fengchao Liang,Xueli Yang,Jie Cao,Shufeng Chen,Dongsheng Hu,Jianfeng Huang,Yang Liu,Xiangfeng Lu,Dongfeng Gu
出处
期刊:Environmental Science & Technology [American Chemical Society]
卷期号:57 (27): 9934-9942 被引量:7
标识
DOI:10.1021/acs.est.3c01460
摘要

Previous studies have established a significant link between ambient fine particulate matter (PM2.5) exposure and atherosclerotic cardiovascular disease (ASCVD) incidence, but whether this association varies across populations with different predicted ASCVD risks was uncertain previously. We included 109,374 Chinese adults without ASCVD at baseline from the Prediction for Atherosclerotic Cardiovascular Disease Risk in China (China-PAR) project. We obtained PM2.5 data of participants' residential address from 2000 to 2015 using a satellite-based spatiotemporal model. Participants were classified into low-to-medium and high-risk groups according to the ASCVD 10-year and lifetime risk prediction scores. Hazard ratios (HRs) and 95% confidence intervals (CIs) for PM2.5 exposure-related incident ASCVD, as well as the multiplication and additive interaction, were calculated using stratified Cox proportional hazard models. The additive interaction between risk stratification and PM2.5 exposure was estimated by the synergy index (SI), the attributable proportion due to the interaction (API), and the relative excess risk due to interaction (RERI). Over the follow-up of 833,067 person-years, a total of 4230 incident ASCVD cases were identified. Each 10 μg/m3 increment of PM2.5 concentration was associated with 18% (HR: 1.18; 95% CI: 1.14–1.23) increased risk of ASCVD in the total population, and the association was more pronounced among individuals having a high predicted ASCVD risk than those having a low-to-medium risk, with the HR (95% CI) of 1.24 (1.19–1.30) and 1.11 (1.02–1.20) per 10 μg/m3 increment in PM2.5 concentration, respectively. The RERI, API, and SI were 1.22 (95% CI: 0.62–1.81), 0.22 (95% CI: 0.12–0.32), and 1.37 (95% CI: 1.16–1.63), respectively. Our findings demonstrate a significant synergistic effect on ASCVD between ASCVD risk stratification and PM2.5 exposure and highlight the potential health benefits of reducing PM2.5 exposure in Chinese, especially among those with high ASCVD risk.
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