Effect of Ambient Particles on Acute Stroke Onset

环境颗粒物对急性中风发作的影响

• 批准号: 6939093
• 负责人: MURRAY A MITTLEMAN
• 金额: $ 21.58万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-04-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6939093
• 关键词: air pollution; air sampling /monitoring; cardiovascular disorder epidemiology; cardiovascular disorder risk; clinical research; disease /disorder onset; environmental exposure; human subject; nervous system disorder epidemiology; particle; stroke

Stroke is a leading cause of long-term disability in the US and the third leading cause of death after heart disease and cancer. The identification of triggers of stroke onset is of significant public health interest. Many epidemiologic studies have found an association between short-term increases in particulate air pollution and cardiovascular morbidity and mortality. These effects are likely mediated by neural, hematologic, and inflammatory responses to inhaled particles. Exposure to particulate matter may also increase the risk of ischemic stroke. Recent studies using administrative databases have reported equivical results. Accordingly, the goal of this Project is to quantitatively evaluate the association between short-term increases in ambient particulate matter and the risk of acute ischemic stroke. Specifically, we will evaluate: 1) the association between short-term increases in particulate matter and the risk of acute ischemic stroke, 2) the time course of this effect, 3) the specific constituents of ambient particulate matter to which the effect is most likely attributable, and 4) variation in effect magnitude by etiological subtype of ischemic stroke. To accomplish these aims we will use the services and expertise of the PPG Cores and will apply the case-crossover methodology to the study of 1200 patients hospitalized with acute ischemic stroke. Even though the magnitude of any effect is expected to be small, given the large number of people simultaneously at risk for stroke and exposed to urban air pollution, the attributable risk may be quite significant. Clarifying the impact of particulate air pollution on stroke onset is important for regulatory agencies. Additionally, information about the time course of the effect and identification of important particle constituents may provide insight into the mechanisms of particulate-induced cardiovascular events.

中风是美国长期残疾的主要原因，也是继心脏病和癌症之后的第三大死亡原因。识别中风发作的触发因素具有重要的公共卫生意义。许多流行病学研究发现颗粒物空气污染的短期增加与心血管疾病发病率和死亡率之间存在关联。这些影响可能是由对吸入颗粒的神经、血液和炎症反应介导的。接触颗粒物也可能增加缺血性中风的风险。最近使用管理数据库的研究报告了相同的结果。因此，该项目的目标是定量评估环境颗粒物短期增加与急性缺血性中风风险之间的关联。具体来说， 我们将评估：1）颗粒物短期增加与急性缺血性中风风险之间的关联，2）这种影响的时间进程，3）最有可能归因于该影响的环境颗粒物的具体成分和 4) 不同缺血性中风病因亚型的影响程度的差异。为了实现这些目标，我们将利用 PPG 核心的服务和专业知识，并将病例交叉方法应用于 1200 名因急性缺血性中风住院的患者的研究。尽管任何影响的幅度预计都很小，但考虑到大量的人同时面临中风风险并暴露于城市空气污染中，可归因的风险可能相当大。澄清颗粒物空气污染对中风发病的影响对于监管机构来说非常重要。此外，有关影响的时间过程和重要粒子识别的信息 成分可能有助于深入了解颗粒物诱发的心血管事件的机制。