JAHA:长期PM2.5暴露与缺血性心脏病和卒中风险的关系

2021-01-01 MedSci原创 MedSci原创

长期暴露于PM2.5与IHD死亡率、脑血管死亡率和卒中发生风险增加有关。与心肌梗死的关系提示风险增加,但不是结论性的。需要更多的研究来了解与事件复发的关系。

直径小于2.5 µm的细颗粒物(PM2.5)对血管疾病的发病率和死亡率具有明确的影响。然而,尚无研究量化和比较长期PM2.5暴露引起的心肌梗死卒中、缺血性心脏病(IHD)、死亡和脑血管死亡的风险。

近日,心血管疾病领域权威杂志JAHA上发表了一篇研究文章,研究人员旨在通过对2019年12月31日之前发表的研究进行回顾和荟萃分析,以定量总结PM2.5长期暴露与IHD和卒中事件风险的研究。该研究的主要结局是心肌梗死、卒中、IHD死亡率和脑血管死亡率。随机效应荟萃分析用于评估研究中每种结局的合并风险。

研究人员审查了69项研究,并将42项研究纳入了荟萃分析。在荟萃分析中,研究人员发现长期PM2.5暴露增加10 µg/m3会使IHD死亡率增加23%(95%CI为15%–31%),脑血管死亡风险增加24%(95%CI为13%–36%),卒中事件增加13%(95%CI为11%–15%),心肌梗死事件增加8%(95%CI为-1%至18%)。关于复发性卒中和复发性心肌梗死的研究不足以进行荟萃分析。

由此可见,长期暴露于PM2.5与IHD死亡率、脑血管死亡率和卒中发生风险增加有关。与心肌梗死的关系提示风险增加,但不是结论性的。需要更多的研究来了解与事件复发的关系。

原始出处:

Stacey E. Alexeeff.et al.Long‐Term PM2.5 Exposure and Risks of Ischemic Heart Disease and Stroke Events: Review and Meta‐Analysis.J AM HEART ASSOC.2020.https://doi.org/10.1161/JAHA.120.016890

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href='/topic/show?id=7b80e9367d2' target=_blank style='color:#2F92EE;'>#缺血性心脏病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79367, encryptionId=7b80e9367d2, topicName=缺血性心脏病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3fce464, createdName=ylz8403, createdTime=Sun Jan 03 04:11:48 CST 2021, time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1526839, encodeId=529f1526839f5, content=<a href='/topic/show?id=f72b14404ae' target=_blank style='color:#2F92EE;'>#PM2.5暴露#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=14404, encryptionId=f72b14404ae, topicName=PM2.5暴露)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d69511767818, createdName=3631177, createdTime=Sun Jan 03 04:11:48 CST 2021, time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
    2021-01-03 zhaohui6731
  5. [GetPortalCommentsPageByObjectIdResponse(id=1820437, encodeId=ea40182043eaf, content=<a href='/topic/show?id=c87f10089032' target=_blank style='color:#2F92EE;'>#风险的关系#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100890, encryptionId=c87f10089032, topicName=风险的关系)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Jan 20 18:11:48 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893347, encodeId=feee189334e70, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, 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time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1820437, encodeId=ea40182043eaf, content=<a href='/topic/show?id=c87f10089032' target=_blank style='color:#2F92EE;'>#风险的关系#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100890, encryptionId=c87f10089032, topicName=风险的关系)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Wed Jan 20 18:11:48 CST 2021, time=2021-01-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1893347, encodeId=feee189334e70, content=<a href='/topic/show?id=c738e93521f' target=_blank style='color:#2F92EE;'>#缺血性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=40, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79352, 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time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
  7. 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time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
  8. 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time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
    2021-01-02 土豆2995

    666

    0

  9. 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time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
    2021-01-01 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  10. 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time=2021-01-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=913147, encodeId=2eb991314ecc, content=666, beContent=null, objectType=article, channel=null, level=null, likeNumber=72, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/hVpkYy8lg1kItvlriavHzhx4l36BwvxzOPgZABcEW7lwvrq3ibEKBNtvjpEgzGa9StMWB79jPNkz6zosChP7wq7g/132, createdBy=46805277400, createdName=土豆2995, createdTime=Sat Jan 02 21:16:48 CST 2021, time=2021-01-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026736, encodeId=e67d1026e362d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=41, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045998, encodeId=ed121045998ea, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Fri Jan 01 16:11:48 CST 2021, time=2021-01-01, status=1, ipAttribution=)]
    2021-01-01 guging

    中风是俗称,应该称为缺血性卒中吧

    0

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“中国结构性心脏病的发展,可以说已完成华丽转身。”这是西安交通大学第一附属医院张玉顺教授在接受专访时发出的感叹。中国科促会结构性心脏病大会Ⅲ暨2020中国西部左心耳封堵高峰论坛成功举办。

Neurology:癌症幸存者卒中的风险

癌症在卒中的发病中起着至关重要的作用。由于所纳入研究之间存在较大的异质性,因此应谨慎解释结果。但是,对癌症幸存者卒中的早期预防和有效干预需要引起健康决策者的注意。

JAHA:中国卒中及其亚型的危险因素分析

该研究明确了与传统的卒中及其亚型危险因素相辅相成的社会经济因素,从而有针对性地减少了卒中负担。

Stroke:肝移植患者术后房颤与卒中的长期风险的关系

LT后的POAF与血栓栓塞事件风险增加8倍相关,使用CHA2DS2VASc评分可能有助于这些患者的风险分层。必须进行前瞻性研究,以评估使用口服抗凝剂是否可以降低LT后血栓栓塞的风险。

陆士娟:累积左心耳封堵术的中国数据与经验,开拓中国特色创新之路

左心耳封堵作为房颤综合治疗的重要补充,不仅理论科学、技术可行,而且远期效果确切。LAAC技术在中国虽起步较晚,但发展速度较快,在手术例数、优化患者选择、器械研发、操作技巧以及并发症的防治方面不断取得新