Sunao Kojima1, Takehiro Michikawa2, Kayo Ueda3, Tetsuo Sakamoto4, Kunihiko Matsui5, Tomoko Kojima6, Kenichi Tsujita1, Hisao Ogawa7, Hiroshi Nitta2, Akinori Takami8. 1. Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan. 2. Centre for Health and Environmental Risk Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan. 3. Department of Engineering, Graduate School of Kyoto University, Kyotodaigaku-katsura, Nishikyo-ku, Kyoto 617-8540, Japan. 4. Graduate School of Electrical and Electronics Engineering, Kogakuin University, 2665-1 Nakano-machi, Hachioji, Tokyo 192-0015, Japan. 5. Department of Family, Community, and General Medicine, Kumamoto University Hospital, 1-1-1 Honjo, Chuo-ku, Kumamoto 860-8556, Japan. 6. Department of Earth and Environmental Science, Faculty of Advanced Science and Technology, Kumamoto University, 2-39-1, Kurokami, Chuo-ku, Kumamoto 860-8555, Japan. 7. National Cerebral and Cardiovascular Center, 5-7-1 Fujishirodai, Suita, Osaka 565-8565, Japan. 8. Centre for Regional Environmental Research, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan.
Abstract
AIMS: To elucidate whether Asian dust is associated with the incidence of acute myocardial infarction (AMI) and to clarify whether patients who are highly sensitive to Asian dust will develop AMI. METHODS AND RESULTS: Twenty-one participating institutions located throughout Kumamoto Prefecture and capable of performing coronary intervention were included in the study. Data for ground-level observations of Asian dust events were measured at the Kumamoto Local Meteorological Observatory. Data collected between 1 April 2010 and 31 March 2015 were analysed, and 3713 consecutive AMI patients were included. A time-stratified case-crossover design was applied to examine the association between Asian dust exposure and AMI. The occurrence of Asian dust events at 1 day before the onset of AMI was associated with the incidence of AMI [odds ratio (OR), 1.46; 95% confidence interval (CI), 1.09-1.95] and especially, non-ST-segment elevation myocardial infarction was significant (OR 2.03; 95% CI, 1.30-3.15). A significant association between AMI and Asian dust was observed in patients with age ≥75 years, male sex, hypertension, diabetes mellitus, never-smoking status, and chronic kidney disease (CKD). However, Asian dust events had a great impact on AMI onset in patients with CKD (P < 0.01). A scoring system accounting for several AMI risk factors was developed. The occurrence of Asian dust events was found to be significantly associated with AMI incidence among patients with a risk score of 5-6 (OR 2.45; 95% CI: 1.14-5.27). CONCLUSION: Asian dust events may lead to AMI and have a great impact on its onset in patients with CKD. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: To elucidate whether Asian dust is associated with the incidence of acute myocardial infarction (AMI) and to clarify whether patients who are highly sensitive to Asian dust will develop AMI. METHODS AND RESULTS: Twenty-one participating institutions located throughout Kumamoto Prefecture and capable of performing coronary intervention were included in the study. Data for ground-level observations of Asian dust events were measured at the Kumamoto Local Meteorological Observatory. Data collected between 1 April 2010 and 31 March 2015 were analysed, and 3713 consecutive AMI patients were included. A time-stratified case-crossover design was applied to examine the association between Asian dust exposure and AMI. The occurrence of Asian dust events at 1 day before the onset of AMI was associated with the incidence of AMI [odds ratio (OR), 1.46; 95% confidence interval (CI), 1.09-1.95] and especially, non-ST-segment elevation myocardial infarction was significant (OR 2.03; 95% CI, 1.30-3.15). A significant association between AMI and Asian dust was observed in patients with age ≥75 years, male sex, hypertension, diabetes mellitus, never-smoking status, and chronic kidney disease (CKD). However, Asian dust events had a great impact on AMI onset in patients with CKD (P < 0.01). A scoring system accounting for several AMI risk factors was developed. The occurrence of Asian dust events was found to be significantly associated with AMI incidence among patients with a risk score of 5-6 (OR 2.45; 95% CI: 1.14-5.27). CONCLUSION: Asian dust events may lead to AMI and have a great impact on its onset in patients with CKD. Published on behalf of the European Society of Cardiology. All rights reserved.
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