Air Pollution and Cardiac Arrest: A More Significant Intermediate Role of COPD than Cardiac Events

四分位间距 狼牙棒 危险系数 慢性阻塞性肺病 队列 比例危险模型 医学 空气污染 环境卫生 微粒 心脏病学 内科学 心肌梗塞 置信区间 传统PCI 化学 有机化学
作者
Huihuan Luo,Qingli Zhang,Xia Meng,Haidong Kan,Renjie Chen
出处
期刊:Environmental Science & Technology [American Chemical Society]
卷期号:58 (18): 7782-7790 被引量:4
标识
DOI:10.1021/acs.est.4c00083
摘要

No prior studies have linked long-term air pollution exposure to incident sudden cardiac arrest (SCA) or its possible development trajectories. We aimed to investigate the association between long-term exposure to air pollution and SCA, as well as possible intermediate diseases. Based on the UK Biobank cohort, Cox proportional hazard model was applied to explore associations between air pollutants and SCA. Chronic obstructive pulmonary disease (COPD) and major adverse cardiovascular events (MACE) were selected as intermediate conditions, and multistate model was fitted for trajectory analysis. During a median follow-up of 13.7 years, 2884 participants developed SCA among 458 237 individuals. The hazard ratios (HRs) for SCA were 1.04-1.12 per interquartile range increment in concentrations of fine particulate matter, inhalable particulate matter, nitrogen dioxide, and nitrogen oxides. Most prominently, air pollutants could induce SCA through promoting transitions from baseline health to COPD (HRs: 1.06-1.24) and then to SCA (HRs: 1.16-1.27). Less importantly, SCA could be developed through transitions from baseline health to MACE (HRs: 1.02-1.07) and further to SCA (HRs: 1.12-1.16). This study provides novel and compelling evidence that long-term exposure to air pollution could promote the development of SCA, with COPD serving as a more important intermediate condition than MACE.
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