Effect of Asian dust and PM2.5 for acute myocardial infarction and out-of-hospital cardiac arrest: identification of high-sensitivity group

2019 Fiscal Year Final Research Report

• Project/Area Number: 17K19821
• Research Category: Grant-in-Aid for Challenging Research (Exploratory)
• Allocation Type: Multi-year Fund
• Research Field: Society medicine, Nursing, and related fields
• Research Institution: Kawasaki Medical School (2018-2019); Kumamoto University (2017)
• Principal Investigator: Kojima Sunao 川崎医科大学, 医学部, 教授 (50363528)
• Co-Investigator(Kenkyū-buntansha): 道川 武紘 東邦大学, 医学部, 講師 (80594853)
• Project Period (FY): 2017-06-30 – 2020-03-31
• Keywords: 急性心筋梗塞 / 院外心停止 / 黄砂 / PM2.5 / 危険因子

Outline of Final Research Achievements

(1) Association between acute myocardial infarction (AMI) and Asian dust exposure: A total of 3713 consecutive AMI patients were included. The occurrence of Asian dust events at 1 day before the onset of AMI was associated with the incidence of AMI. 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 high-risk score.
(2) Association between out-of-hospital cardiac arrest (OHCA) of cardiac origin and particulate matter with a diameter of 2.5 μm or smaller (PM2.5): In total, 103 189 OHCAs of cardiac origin witnessed by bystanders were included. Point estimates of the percentage increase for a 10-μg/m3 increase in PM2.5 demonstrated a significantly higher incidence of OHCA. An initial nonshockable rhythm was associated with PM2.5 exposure.

Free Research Field

循環器内科

Academic Significance and Societal Importance of the Research Achievements

急性心筋梗塞や院外心原性心停止の発症には黄砂やPM2.5が関与しており、その発症を予防するためにはこれらの粒子状物質を減らす必要があることが示唆された。
本研究により重篤な循環器疾患発症との関連を見いだすことができたが、特にPM2.5では濃度上昇とともに発症率が増加するという正の相関が見られたことから、発症に対する臨界値を算出することはできなかった。しかし循環器疾患以外の疾患別に検討する必要性があり、今後の日本の粒子状物質の環境基準の設定に大きく影響をおよぼす可能性がある。また今後の検討課題として、粒子中の構成成分を解析することで、粒子状物質による疾患発症のメカニズムを紐解くことが期待される。