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Association of Long-Term Exposure to Particulate Matter and Ozone With Health Status and Mortality in Patients After Myocardial Infarction.

Abstract：

BACKGROUND:Long-term exposure to particulate matter <2.5 µm in diameter (PM2.5) and ozone has been associated with the development and progression of cardiovascular disease and, in the case of PM2.5, higher cardiovascular mortality. Whether exposure to PM2.5 and ozone is associated with patients' health status and quality of life is unknown. We used data from 2 prospective myocardial infarction (MI) registries to assess the relationship between long-term PM2.5 and ozone exposure with health status outcomes 1 year after an MI. METHODS AND RESULTS:TRIUMPH (Translational Research Investigating Underlying Disparities in Acute Myocardial Infarction) and PREMIER (Prospective Registry Evaluating Myocardial Infarction: Events and Recovery) enrolled patients presenting with MI at 31 US hospitals between 2003 and 2008. One year later, patients were assessed with the disease-specific Seattle Angina Questionnaire, and 5-year mortality was assessed with the Centers for Disease Control's National Death Index. Individual patients' exposures to PM2.5 and ozone over the year after their MI were estimated from the Environment Protection Agency's Fused Air Quality Surface Using Downscaling tool that integrates monitoring station data and atmospheric models to predict daily air pollution exposure at the census tract level. We assessed the association of exposure to ozone and PM2.5 with 1-year health status and mortality over 5 years using regression models adjusting for age, sex, race, socioeconomic status, date of enrollment, and comorbidities. In completely adjusted models, higher PM2.5 and ozone exposure were independently associated with poorer Seattle Angina Questionnaire summary scores at 1-year (β estimate per +1 SD increase =-0.8 [95% CI, -1.4 to -0.3; P=0.002] for PM2.5 and -0.9 [95% CI, -1.3 to -0.4; P<0.001] for ozone). Moreover, higher PM2.5 exposure, but not ozone, was independently associated with greater mortality risk (hazard ratio =1.13 per +1 SD [95% CI, 1.07-1.20; P<0.001]). CONCLUSIONS:In our study, greater exposure to PM2.5 and ozone was associated with poorer 1-year health status following an MI, and PM2.5 was associated with increased risk of 5-year death.

journal_name

Circ Cardiovasc Qual Outcomes

journal_title

Circulation. Cardiovascular quality and outcomes

authors

Malik AO,Jones PG,Chan PS,Peri-Okonny PA,Hejjaji V,Spertus JA

doi

10.1161/CIRCOUTCOMES.119.005598

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

e005598

issue

eissn

1941-7713

issn

1941-7705

journal_volume

pub_type

杂志文章,多中心研究

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Association of Long-Term Exposure to Particulate Matter and Ozone With Health Status and Mortality in Patients After Myocardial Infarction.