A case-crossover study on the effect of short-term exposure to moderate levels of air pollution on the risk of heart failure.

Autor: Huschmann A; Hans Berger Department of Neurology, Jena University Hospital, Jena, 07747, Germany., Rasche M; Department of Pediatrics, Jena University Hospital, Jena, 07747, Germany., Schlattmann P; Institute of Medical Statistics, Computer Sciences and Documentation, Jena University Hospital, Jena, 07747, Germany., Witte OW; Hans Berger Department of Neurology, Jena University Hospital, Jena, 07747, Germany., Schwab M; Hans Berger Department of Neurology, Jena University Hospital, Jena, 07747, Germany., Schulze PC; Department of Internal Medicine I, Jena University Hospital, Jena, 07747, Germany., Rakers F; Hans Berger Department of Neurology, Jena University Hospital, Jena, 07747, Germany.
Jazyk: angličtina
Zdroj: ESC heart failure [ESC Heart Fail] 2020 Dec; Vol. 7 (6), pp. 3851-3858. Date of Electronic Publication: 2020 Sep 13.
DOI: 10.1002/ehf2.12977
Abstrakt: Aims: Exposure to high levels of air pollution in industrialized urban areas is associated with an increased risk of heart failure (HF). On most days, the majority of European cities are only moderately affected by air pollution. The aim of this study was to evaluate the association between short-term exposure to moderate levels of air pollution with the risk of HF in a city with good air quality.
Methods and Results: We recruited 576 patients (median age 82 years; 58.2% men) admitted to a large university hospital in Central Germany for HF to participate in a hospital-based, bidirectional, case-crossover study. Diagnosis of HF and symptom onset were verified individually. The effect of short-term exposure to nitrogen dioxide (NO 2 ), particulate matter (PM 10 ), and ozone (O 3 ) on the risk of HF was estimated using linear and non-linear (categorized) multivariate analyses for three different lag times (1, 2, and 3 days before HF onset). Air pollution variables were adjusted to the date of HF symptom onset. During the study period, the average daily concentration of air pollutants was only moderate and reflects the average European background air pollution. In particular, the concentration of air pollutants ranged from 2 to 63.39 μg/m 3 (median = 17.46 μg/m 3 ) for NO 2 , from 2 to 125.88 μg/m 3 (median = 44.61 μg/m 3 ) for O 3 , and from 2.21 to 166.79 μg/m 3 (median = 18.67 μg/m 3 ) for PM 10 . We did not find a linear or non-linear association between short-term exposure to NO 2 , O 3 , or PM 10 and risk for HF at all lag times in the overall population and subgroups.
Conclusions: In an area with only moderate air pollution, short-term exposure to major air pollutants does not increase the risk for HF. Future studies should focus on a potential threshold effect of air pollution on HF risk as a basis for evidence-based development of statutory limits in highly polluted areas.
(© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of European Society of Cardiology.)
Databáze: MEDLINE
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