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Ambient air pollution and CVD
Table 1. Results of recent systematic reviews and meta-analyses of the short- and long-term association between particulate matter air pollution and cardiovas- cular diseases.
Author, yearref.
Nawrot, 201158
Mustafic,201259
Shah,201360
Hoek,201361
Atkinson, 201462
Wang,201463
Shah,201564
Luo, 201565
Lu, 201566
Cai,201667
Song, 201668
Tang, 201669 Shao,201670
Achilleos,201771
Newell,201772
Zhao, 201773
Zhao,201774
Liu,201875
Vodonos,201876
Study investigation goals
Short-term association between PM and AMI
Short-termassociationbetweenPMandriskofAMI
Short-termassociationbetweendailyincreasesofPM and heart failure hospitalization or mortality
Long-termassociationbetweenPMand
cardio-respiratory mortality Short-term association between PM2.5 exposure
Short-termassociationbetweendailyPMincreases and stroke hospitalization or mortality
Short-termassociationbetweendailyPMincreases and stroke hospitalization
Relationship between short-term PM exposure and AMI
Short-term effects of PM exposure on cardiovascular mortality
Short-termassociationbetweenPMlevelsand hospitalization or mortality for AMI
Short-term association between PM and arrhythmia hospitalization or mortality
Association between PM and venous thrombosis
Short-termassociationbetweenPManddevelopment of atrial fibrillation
Short-termeffectsofPMonmortality
Short-termandlong-termcardiovasculareffects of PM in low- and middle-income countries
Short-term association between PM and cardiac arrest
Short-termassociationbetweenPMandcardiovascular mortality in China
Long-termeffectsofPMoncardiovascularmortality
Long-termeffectsofPM oncardiovascularmortality 2.5
Main results
Studies included/events
14/593,480
34/n.a.
35/~2.4million
11/n.a.
110/ n.a.
45/n.a.
94/6.2million
31/ n.a.
59/218 million
25/n.a.
23/2 million
8/700,000 4/461,441
41/-
85/-
15/-
30/-
16/542,991
53/-
Increase in PM was associated with non-fatal AMI 10
3
(OR: 1.02 per 10 μg/m ; 95% CI 1.01-1.02)
IncreasesinPM andPM wereassociatedwiththeriskofAMI 2.5 10
3
(OR: 1.025 per 10 μg/m ; 95% CI 1.015-1.036 and 1.006
per 10 μg/m3; 95% CI 1.002-1.009, respectively) IncreasesinPM andPM wereassociatedwithadmission
2.5 10
and mortality for heart failure (2.12% per 10 μg/m ;
3
95% CI 1.42-2.82 and 1.63% per 10 μg/m3; 95% CI 1.20-2.07, respectively)
IncreaseinPM wasassociatedwithcardiovascularmortality 2.5
3
(6% per 10 μg/m ; 95% CI 4-8).
Increases in PM2.5 were associated with emergency
and risk of death and emergency hospital admissions
and mortality for cardiovascular diseases (0.90% per 10 μg/m3; 95% CI 0.26-1.53 and 0.84% per 10μg/m3; 95% CI 0.41-1.28, respectively)
IncreasesinPM andPM wereassociatedwithcerebrovascular 2.5 10
3
mortality (RR: 1.014 per 10 μg/m ; 95% CI 1.009-1.019 and
1.005 per 10 μg/m3; 95% CI 1.003-1.007, respectively) IncreasesinPM andPM wereassociatedwithhospitaladmission
2.5 10
and mortality for stroke (RR: 1.011 per 10 μg/m ; 95% CI 1.011-1.012
3
and 1.003 per 10 μg/m3; 95% CI 1.002-1.004, respectively)
Increases in PM and PM were associated with the risk of AMI 2.5 10
33 (OR: 1.022 per 10 μg/m ; 95% CI 1.015-1.030 and 1.005 per 10 μg/m ;
95% CI 1.001-1.008, respectively)
Increases in PM and PM were associated with cardiovascular 2.5 10
33 mortality (0.63% per 10 μg/m ; 95% CI 0.35-0.91 and 0.36 per 10 μg/m ;
95% CI 0.24-0.49, respectively)
IncreasesinPM wereassociatedwiththeriskofhospitalization 2.5
3 and mortality for AMI (RR: 1.024 per 10 μg/m ;
95% CI 1.007-1.041 and 1.012 per 10 μg/m3; 95% CI 1.010-1.015, respectively).IncreasesinPM wereassociatedwithrisk
10
of hospitalization and mortality for AMI (OR: 1.011 per 10 μg/m ;
95% CI 1.006-1.016 and 1.008 per 10 μg/m3; 95% CI 1.004-1.012, respectively)
3
Arrhythmia hospitalization or mortality were associated with
increases in PM (RR: 1.015 per 10 μg/m3; 95% CI 1.006-1.024) 2.5
3
andPM (RR:1.009per10μg/m;95%CI1.004-1.014)
10
No association between PM exposure and venous thrombosis
IncreaseinPM wasassociatedwithatrialfibrillationdevelopment 2.5
3
(RR: 1.009 per 10 μg/m ; 95% CI 1.002-1.016).
A10μg/m3ofPM increasewasassociatedwitha0.80% 2.5
(95% CI 0.41-1.20) increase in cardiovascular mortality
Increasesinsame-dayPM andPM wereassociatedwith 2.5 10
3
cardiovascular mortality (0.47% per 10 μg/m ; 95% CI 0.34-0.61
and 0.27 per 10 μg/m3; 95% CI 0.11-0.44, respectively)
Acute exposure to PM2.5 and PM10 was associated with an increased risk of cardiac arrest (RR: 1.041; 95% CI 1.012-1.071) and PM10 (RR: 1.021; 95% CI 1.006-1.037)
IncreasesinPM andPM wereassociatedwithincreased 2.5 10
3
cardiovascular mortality (0.68% per 10 μg/m ; 95% CI 0.39-0.97
and 0.39 per 10 μg/m3; 95% CI 0.26-0.53, respectively) IncreaseinPM wasassociatedwithincreasedcardiovascular
2.5
mortality (HR: 1.12 per 10 μg/m ; 95% CI 1.08-1.16). Increase
3
in PM10 was not associated with cardiovascular mortality.
IncreaseinPM wasassociatedwithcardiovascularmortality 2.5
3
(1.46% per 10 μg/m ; 95% CI 1.25-1.67).
AMI: acute myocardial infarction; n.a.: not available; RR: relative risk; PM: particulate matter; OR: odds ratio; HR: hazard ratio.
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