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      Relation between Accumulated Air Pollution Exposure and Sub-Clinical Cardiovascular Disease in 33,723 Danish 60–74-Year-Old Males from the Background Population (AIR-CARD): A Method Article

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          Abstract

          Cardiovascular disease is one of the main causes of death and disability in the Western world, and there is increasing evidence that air pollution is a risk factor for developing sub-clinical cardiovascular diseases. Previous studies have shown a correlation between cardiovascular disease and short-term exposure to elevated air pollution levels. However, the literature on the impact of long-term effect of air pollution is limited. We have a unique opportunity to evaluate this correlation. The DEHM/UBM/AirGIS model system calculates air pollution in a high temporal and spatial resolution and traces air pollution retrospectively to year 1979. The model calculates accumulated exposure using annual exposure from PM<sub>2.5</sub> in relation to home and work addresses and takes into account working hours and holidays. We link the results from this model system to a population-based cardiovascular screening cohort of 33,723 individuals in the age of 60–74 to assess the contribution of the specific accumulated air pollution to the presence of sub-clinical arteriosclerosis in the coronary vessels, abdominal aortic aneurysms, and peripheral arterial disease. This correlation will be further analyzed in relation to specific air pollutants. This study will introduce more precise data for a longer period of time and incorporate participant’s home and work addresses.

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          Alternative projections of mortality and disability by cause 1990–2020: Global Burden of Disease Study

          Christopher Murray, Alan Lopez (1997)
          The Lancet, 349(9064), 1498-1504
          Article 0 comments Cited 1149 times – based on 0 reviews     Review now
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            Is Open Access

            Long-term air pollution exposure and cardio- respiratory mortality: a review

            Gerard Hoek, Ranjini Krishnan, Rob Beelen … (2013)
            Current day concentrations of ambient air pollution have been associated with a range of adverse health effects, particularly mortality and morbidity due to cardiovascular and respiratory diseases. In this review, we summarize the evidence from epidemiological studies on long-term exposure to fine and coarse particles, nitrogen dioxide (NO2) and elemental carbon on mortality from all-causes, cardiovascular disease and respiratory disease. We also summarize the findings on potentially susceptible subgroups across studies. We identified studies through a search in the databases Medline and Scopus and previous reviews until January 2013 and performed a meta-analysis if more than five studies were available for the same exposure metric. There is a significant number of new studies on long-term air pollution exposure, covering a wider geographic area, including Asia. These recent studies support associations found in previous cohort studies on PM2.5. The pooled effect estimate expressed as excess risk per 10 μg/m3 increase in PM2.5 exposure was 6% (95% CI 4, 8%) for all-cause and 11% (95% CI 5, 16%) for cardiovascular mortality. Long-term exposure to PM2.5 was more associated with mortality from cardiovascular disease (particularly ischemic heart disease) than from non-malignant respiratory diseases (pooled estimate 3% (95% CI −6, 13%)). Significant heterogeneity in PM2.5 effect estimates was found across studies, likely related to differences in particle composition, infiltration of particles indoors, population characteristics and methodological differences in exposure assessment and confounder control. All-cause mortality was significantly associated with elemental carbon (pooled estimate per 1 μg/m3 6% (95% CI 5, 7%)) and NO2 (pooled estimate per 10 μg/m3 5% (95% CI 3, 8%)), both markers of combustion sources. There was little evidence for an association between long term coarse particulate matter exposure and mortality, possibly due to the small number of studies and limitations in exposure assessment. Across studies, there was little evidence for a stronger association among women compared to men. In subjects with lower education and obese subjects a larger effect estimate for mortality related to fine PM was found, though the evidence for differences related to education has been weakened in more recent studies.
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              Long-term prognosis associated with coronary calcification: observations from a registry of 25,253 patients.

              Matthew Budoff, Leslee J Shaw, Sandy Liu … (2007)
              The purpose of this study was to develop risk-adjusted multivariable models that include risk factors and coronary artery calcium (CAC) scores measured with electron-beam tomography in asymptomatic patients for the prediction of all-cause mortality. Several smaller studies have documented the efficacy of CAC testing for assessment of cardiovascular risk. Larger studies with longer follow-up will lend strength to the hypothesis that CAC testing will improve outcomes, cost-effectiveness, and safety of primary prevention efforts. We used an observational outcome study of a cohort of 25,253 consecutive, asymptomatic individuals referred by their primary physician for CAC scanning to assess cardiovascular risk. Multivariable Cox proportional hazards models were developed to predict all-cause mortality. Risk-adjusted models incorporated traditional risk factors for coronary disease and CAC scores. The frequency of CAC scores was 44%, 14%, 20%, 13%, 6%, and 4% for scores of 0, 1 to 10, 11 to 100, 101 to 400, 401 to 1,000, and >1,000, respectively. During a mean follow-up of 6.8 +/- 3 years, the death rate was 2% (510 deaths). The CAC was an independent predictor of mortality in a multivariable model controlling for age, gender, ethnicity, and cardiac risk factors (model chi-square = 2,017, p 1,000, respectively (p 1,000 (p < 0.0001). This large observational data series shows that CAC provides independent incremental information in addition to traditional risk factors in the prediction of all-cause mortality.
              Article 0 comments Cited 281 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (publisher-id): CRD
                Journal ID (nlm-ta): Cardiology
                Journal ID (doi): 10.1159/issn.0008-6312
                Title: Cardiology
                Publisher: S. Karger AG
                ISSN (Print): 0008-6312
                ISSN (Electronic): 1421-9751
                Publication date Subscription-year: 2021
                Publication date (Print): January 2021
                Publication date (Electronic): 25 November 2020
                Volume: 146
                Issue: 1
                Pages: 19-26
                Affiliations
                [_a] aCardiovascular Research Unit, Odense University Hospital – Svendborg, Svendborg, Denmark
                [_b] bDepartment of Clinical Epidemiology, Odense University Hospital, Odense, Denmark
                [_c] cDepartment of Cardiology, Sygehus Lillebælt, Lillebaelt, Denmark
                [_d] dDepartment of Environmental Science, Faculty of Technical Sciences, Aarhus University, Aarhus, Denmark
                [_e] eDepartment of Cardiology, Odense University Hospital, Odense, Denmark
                [_f] fDepartment of Cardiothoracic and Vascular Surgery T, Odense University Hospital, Odense, Denmark
                Author notes
                *Jess Lambrechtsen, Cardiovascular Research Unit, Odense University Hospital – Svendborg, Baagøes Allé 31, DK–5700 Svendborg (Denmark), Jess.Lambrechtsen@rsyd.dk
                Author information
                https://orcid.org/0000-0002-1285-4826
                Article
                Publisher ID: 511128 Other ID: Cardiology 2021;146:19–26
                DOI: 10.1159/000511128
                PubMed ID: 33238279
                SO-VID: a7344495-634c-4314-9ad5-e49126cbdc28
                Copyright © © 2020 S. Karger AG, Basel
                License:

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                History
                Date received : 27 May 2020
                Date accepted : 17 August 2020
                Page count
                Figures: 2, Pages: 8
                Categories
                Subject: CAD and AMI: Clinical Trial Design

                ScienceOpen disciplines: General medicine,Neurology,Cardiovascular Medicine,Internal medicine,Nephrology
                Keywords: DEHM/UBM/AirGIS,Viborg Vascular trial,Environmental exposure,DANCAVAS,Sub-clinical arteriosclerosis,Cardiovascular disease,Particulate matter,Air pollution
                Data availability:
                ScienceOpen disciplines: General medicine, Neurology, Cardiovascular Medicine, Internal medicine, Nephrology
                Keywords: DEHM/UBM/AirGIS, Viborg Vascular trial, Environmental exposure, DANCAVAS, Sub-clinical arteriosclerosis, Cardiovascular disease, Particulate matter, Air pollution

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