Systemic effects of controlled exposure to diesel exhaust: a meta-analysis from randomized controlled trials.

Autor: Vieira JL; a Department of Heart Failure , Heart Institute (InCor), University of Sao Paulo Medical School , Sao Paulo , Brazil., Macedo FY; b Department of Cardiology, Baylor College of Medicine , Houston , TX , USA., Benjo AM; c Department of Cardiology , Pima Heart Institute , Tucson , AZ , USA., Guimarães GV; a Department of Heart Failure , Heart Institute (InCor), University of Sao Paulo Medical School , Sao Paulo , Brazil., Contreras JP; d Department of Cardiology , Heart and Failure Transplant, Mount Sinai Hospital , New York , NY , USA., Bocchi EA; a Department of Heart Failure , Heart Institute (InCor), University of Sao Paulo Medical School , Sao Paulo , Brazil.
Jazyk: angličtina
Zdroj: Annals of medicine [Ann Med] 2017 Mar; Vol. 49 (2), pp. 165-175. Date of Electronic Publication: 2016 Nov 18.
DOI: 10.1080/07853890.2016.1252054
Abstrakt: Introduction: Ambient air pollution is associated with adverse cardiovascular events. This meta-analysis aimed to investigate the short-term association between air pollution and cardiovascular effects on healthy volunteers.
Methods: We searched databases to identify randomized trials with controlled human exposures to either of two models for studying ambient particulate matter: diesel-exhaust or concentrated ambient particles. Estimates of size effect were performed using standardized mean difference (SMD). Heterogeneity was assessed with I 2 statistics. Outcomes were vascular function estimated by forearm blood flow (FBF), blood pressure, heart rate, and blood analysis.
Results: Database searches yielded 17 articles (n = 342) with sufficient information for meta-analyses. High levels of heterogeneity for the some outcomes were analyzed using random-effects model. The pooled effect estimate showed that short-term exposure to air pollution impaired FBF response from 2.7 to 2.5 mL/100 mL tissue/min (SMD 0.404; p = .006). There was an increase in 5000 platelet/mm 3 following pollution exposure (SMD 0.390; p = .050) but no significant differences for other outcomes.
Conclusion: Controlled human exposures to air pollution are associated with the surrogates of vascular dysfunction and increase in platelet count, which might be related to adverse cardiovascular events. Given the worldwide prevalence of exposure to air pollution, these findings are relevant for public health. KEY MESSAGES Controlled exposure to air pollution impairs vasomotor response, which is a surrogate for adverse cardiovascular events. This is the first meta-analysis from randomized clinical trials showing short-term association between air pollution and cardiovascular effects on healthy volunteers. Given the worldwide prevalence of exposure to air pollution, this finding is important for public health.
Databáze: MEDLINE
Externí odkaz: