| Autor: |
Tan BY; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Division of Neurology, Department of Medicine, National University Health System, Singapore 169857, Singapore., Ho JSY; School of Clinical Medicine, University of Cambridge, Cambridge CB2 0QQ, UK., Ho AF; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Rd., Singapore 169608, Singapore.; Pre-Hospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore., Pek PP; Pre-Hospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore., Leow AS; Division of Neurology, Department of Medicine, National University Health System, Singapore 169857, Singapore., Raju Y; Environmental Monitoring and Modelling Division, Environmental Quality Monitoring Department, National Environment Agency, Singapore 228231, Singapore., Sia CH; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore., Yeo LL; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Division of Neurology, Department of Medicine, National University Health System, Singapore 169857, Singapore., Sharma VK; Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore.; Division of Neurology, Department of Medicine, National University Health System, Singapore 169857, Singapore., Ong ME; Department of Emergency Medicine, Singapore General Hospital, 1 Outram Rd., Singapore 169608, Singapore.; Pre-Hospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore., Aik J; Pre-Hospital and Emergency Research Centre, Health Services and Systems Research, Duke-NUS Medical School, Singapore 169857, Singapore.; Environmental Epidemiology and Toxicology Division, National Environment Agency, Singapore 228231, Singapore., Zheng H; National Registry of Diseases Office, Health Promotion Board, Singapore 168937, Singapore. |
| Abstrakt: |
Acute ischemic strokes (AIS) are closely linked with air pollution, and there is some evidence that traditional cardiovascular risk factors may alter the relationship between air pollution and strokes. We investigated the effect of atrial fibrillation (AF) on the association of AIS with air pollutants. This was a nationwide, population-based, case-only study that included all AIS treated in public healthcare institutions in Singapore from 2009 to 2018. Using multivariable logistic regression, adjusted for time-varying meteorological effects, we examined how AF modified the association between AIS and air pollutant exposure. A total of 51,673 episodes of AIS were included, with 10,722 (20.7%) having AF. The odds of AIS in patients with AF is higher than those without AF for every 1 µg/m 3 increase in O 3 concentration (adjusted OR [aOR]: 1.005, 95% CI 1.003-1.007) and every 1 mg/m 3 increase in CO concentration (aOR: 1.193, 95% CI 1.050-1.356). However, the odds of AIS in patients with AF is lower than those without AF for every 1 µg/m 3 increase in SO 2 concentration (aOR: 0.993, 95% CI 0.990-0.997). Higher odds of AIS among AF patients as O 3 - and CO concentrations increase are also observed in patients aged ≥65 years and non-smokers. The results suggest that AF plays an important role in exacerbating the risk of AIS as the levels of O 3 and CO increase. |
