Effect of Exhaust- and Nonexhaust-Related Components of Particulate Matter on Long-Term Survival After Stroke.
Stroke
; 47(12): 2916-2922, 2016 12.
Article
em En
| MEDLINE
| ID: mdl-27811334
ABSTRACT
BACKGROUND AND PURPOSE:
Outdoor air pollution represents a potentially modifiable risk factor for stroke. We examined the link between ambient pollution and mortality up to 5 years poststroke, especially for pollutants associated with vehicle exhaust.METHODS:
Data from the South London Stroke Register, a population-based register covering an urban, multiethnic population, were used. Hazard ratios (HR) for a 1 interquartile range increase in particulate matter <2.5 µm diameter (PM2.5) and PM <10 µm (PM10) were estimated poststroke using Cox regression, overall and broken down into exhaust and nonexhaust components. Analysis was stratified for ischemic and hemorrhagic strokes and was further broken down by Oxford Community Stroke Project classification.RESULTS:
The hazard of death associated with PM2.5 up to 5 years after stroke was significantly elevated (P=0.006) for all strokes (HR=1.28; 95% confidence interval [CI], 1.08-1.53) and ischemic strokes (HR, 1.32; 95% CI, 1.08-1.62). Within ischemic subtypes, PM2.5 pollution increased mortality risk for total anterior circulation infarcts by 2-fold (HR, 2.01; 95% CI, 1.17-3.48; P=0.012) and by 78% for lacunar infarcts (HR, 1.78; 95% CI, 1.18-2.66; P=0.006). PM10 pollution was associated with 45% increased mortality risk for lacunar infarct strokes (HR, 1.45; 95% CI, 1.06-2.00; P=0.022). Separating PM2.5 and PM10 into exhaust and nonexhaust components did not show increased mortality.CONCLUSIONS:
Exposure to certain outdoor PM pollution, particularly PM2.5, increased mortality risk poststroke up to 5 years after the initial stroke.Palavras-chave
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Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Sistema de Registros
/
Acidente Vascular Cerebral
/
Poluentes Atmosféricos
/
Poluição do Ar
/
Material Particulado
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Stroke
Ano de publicação:
2016
Tipo de documento:
Article