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ONSET - Air
pollution as a trigger for Myocardial infarction - Importance of
gene-environment interactions
Several studies in the last decade
have confirmed that daily variations in ambient air pollution levels are
associated with daily variations in hospital admissions and mortality from
cardiovascular disease. There is a great need for studies that can
identify susceptible segments of the population, and only lirnited
evidence is available on air pollution as a trigger for acute myocardial
infarction (AMI). Furthermore, the role of genetic factors for the
relation between ai pollution and cardiovascular events has not been
studie d previously. Some studies suggest that increased levels in the low
to moderate lange show a stronger association with negative health effects
than the same increase in the high leve lange. If these results can be
commned there is a potential for improving public health by reducing air
pollution in Swedish cities.
The aim of the
proposed study is to analyze the relation between daily variations in air
pollution levels and the risk for onset of AMI. The study will also
include analyses of interactions between air pollution and individual
genetic factors and other triggers for AMI.
The proposal
project is based on the population based case-control study SHEEP
(Stockholm Heart Epiderniology Program). The surviving cages in SHEEP were
interviewed a short time arter their AMI about exposures to possible
triggers irnmediately before symptoms. The association between AMI and air
pollution will be studied with the case- crossover methodology that makes
it possible to compare, for each subject, the air pollution levels in the
time period immediately preceding the AMI ("case-period") to the
levels in "control-periods" when the subject did not have an
AMI. For a subset of the subjects a blood sample has been drawn which made
it possible to perform genetic analyses. Most of the data have already
been collected in the SHEEP study which makes this project very
cost-efficient. It prirnarily includes completion of the DNA analyses and
supplementation with daily air pollution leveis. The results from the
study will be published in the scientific literature and presented at
scientific conferences international ly as weIl as in Sweden. Results of
national interest will be presented at press conferences as weIl as to
local and central authorities.
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