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• W3085754993 abstract "<h3>Importance</h3> Air pollution is associated with cardiovascular outcomes. Specifically, fine particulate matter measuring 2.5 μm or less (PM_2.5) is associated with thrombosis, stroke, and myocardial infarction. Few studies have examined particulate matter and stroke risk in individuals with atrial fibrillation (AF). <h3>Objective</h3> To assess the association of residential-level pollution exposure in 1 year and ischemic stroke in individuals with AF. <h3>Design, Setting, and Participants</h3> This cohort study included 31 414 individuals with AF from a large regional health care system in an area with historically high industrial pollution. All participants had valid residential addresses for geocoding and ascertainment of neighborhood-level income and educational level. Participants were studied from January 1, 2007, through September 30, 2015, with prospective follow-up through December 1, 2017. Data analysis was performed from March 14, 2018, to October 9, 2019. <h3>Exposures</h3> Exposure to PM_2.5ascertained using geocoding of addresses and fine-scale air pollution exposure surfaces derived from a spatial saturation monitoring campaign and land-use regression modeling. Exposure to PM_2.5was estimated annually across the study period at the residence level. <h3>Main Outcomes and Measures</h3> Multivariable-adjusted stroke risk by quartile of residence-level and annual PM_2.5exposure. <h3>Results</h3> The cohort included 31 414 individuals (15 813 [50.3%] female; mean [SD] age, 74.4 [13.5] years), with a median follow-up of 3.5 years (interquartile range, 1.6-5.8 years). The mean (SD) annual PM_2.5exposure was 10.6 (0.7) μg/m³. A 1-SD increase in PM_2.5was associated with a greater risk of stroke after both adjustment for demographic and clinical variables (hazard ratio [HR], 1.08; 95% CI, 1.03-1.14) and multivariable adjustment that included neighborhood-level income and educational level (HR, 1.07; 95% CI, 1.00-1.14). The highest quartile of PM_2.5exposure had an increased risk of stroke relative to the first quartile (HR, 1.36; 95% CI, 1.18-1.58). After adjustment for clinical covariates, income, and educational level, risk of stroke remained greater for the highest quartile of exposure relative to the first quartile (HR, 1.21; 95% CI, 1.01-1.45). <h3>Conclusions and Relevance</h3> This large cohort study of individuals with AF identified associations between PM_2.5and risk of ischemic stroke. The results suggest an association between fine particulate air pollution and cardiovascular disease and outcomes." @default.
• W3085754993 created "2020-09-21" @default.
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• W3085754993 date "2020-09-15" @default.
• W3085754993 modified "2023-10-14" @default.
• W3085754993 title "Association of Fine Particulate Matter and Risk of Stroke in Patients With Atrial Fibrillation" @default.
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• W3085754993 doi "https://doi.org/10.1001/jamanetworkopen.2020.11760" @default.
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