Elemental carbon exposure at residence and survival after acute myocardial infarction
Authors
von Klot, StephanieGryparis, Alexandros
Tonne, Cathryn
Yanosky, Jeffrey
Coull, Brent A.
Goldberg, Robert J.
Lessard, Darleen M.
Melly, Steven J.
Suh, Helen H.
Schwartz, Joel
UMass Chan Affiliations
Department of Medicine, Division of Cardiovascular MedicineDocument Type
Journal ArticlePublication Date
2009-03-18Keywords
Acute DiseaseAdult
Aged
Aged, 80 and over
Air Pollutants
Carbon
Environmental Exposure
Female
Humans
Male
Massachusetts
Middle Aged
Myocardial Infarction
Proportional Hazards Models
Survival Analysis
Vehicle Emissions
Bioinformatics
Biostatistics
Epidemiology
Health Services Research
Metadata
Show full item recordAbstract
BACKGROUND: Particulate air pollution has been consistently related to cardiovascular mortality. Some evidence suggests that particulate matter may accelerate the atherosclerotic process. Effects of within-city variations of particulate air pollution on survival after an acute cardiovascular event have been little explored. METHODS: We conducted a cohort study of hospital survivors of acute myocardial infarction (MI) from the Worcester, MA, metropolitan area to investigate the long-term effects of within-city variation in traffic-related air pollution on mortality. The study builds on an ongoing community-wide investigation examining changes over time in MI incidence and case-fatality rates. We included confirmed cases of MI in 1995, 1997, 1999, 2001, and 2003. Long-term survival status was ascertained through 2005. A validated spatiotemporal land use regression model for traffic-related air pollution was developed and annual averages of elemental carbon at residence estimated. The effect of estimated elemental carbon on the long-term mortality of patients discharged after MI was analyzed using a Cox proportional hazards model, controlling for a variety of demographic, medical history, and clinical variables. RESULTS: Of the 3895 patients with validated MI, 44% died during follow-up. Exposure to estimated elemental carbon in the year of entry into the study was 0.44 microg/m on average. All-cause mortality increased by 15% (95% confidence interval = 0.03%-29%) per interquartile range increase in estimated yearly elemental carbon (0.24 microg/m) after the second year of survival. No association between traffic-related pollution and all-cause mortality was observed during the first 2 years of follow-up. CONCLUSIONS: Chronic traffic-related particulate air pollution is associated with increased mortality in hospital survivors of acute MI after the second year of survival.Source
Epidemiology. 2009 Jul;20(4):547-54. Link to article on publisher's siteDOI
10.1097/EDE.0b013e31819d9501Permanent Link to this Item
http://hdl.handle.net/20.500.14038/47214PubMed ID
19289965Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1097/EDE.0b013e31819d9501