Air pollution is associated with ischemic stroke via cardiogenic embolism

Jong Won Chung, Oh Young Bang, Kangmo Ahn, Sang Soon Park, Tai Hwan Park, Jae Guk Kim, Youngchai Ko, Soo Joo Lee, Kyung Bok Lee, Jun Lee, Kyusik Kang, Jong Moo Park, Yong Jin Cho, Keun Sik Hong, Hyun Wook Nah, Dae Hyun Kim, Jae Kwan Cha, Wi Sun Ryu, Dong Eog Kim, Joon Tae KimJay Chol Choi, Mi Sun Oh, Kyung Ho Yu, Byung Chul Lee, Ji Sung Lee, Juneyoung Lee, Hong Kyun Park, Beom Joon Kim, Moon Ku Han, Hee Joon Bae

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Background and Purpose - The aim of the study was to assessed the impact of short-term exposure to air pollution on ischemic stroke subtype, while focusing on stroke caused via cardioembolism. Methods - From a nationwide, multicenter, prospective, stroke registry database, 13 535 patients with acute ischemic stroke hospitalized to 12 participating centers were enrolled in this study. Data on the hourly concentrations of particulate matter <10 μm, nitrogen dioxide (NO2), sulfur dioxide (SO2), ozone (O3), and carbon monoxide (CO) were collected from 181 nationwide air pollution surveillance stations. The average values of these air pollutants over the 7 days before stroke onset from nearest air quality monitoring station in each patient were used to determine association with stroke subtype. The primary outcome was stroke subtype, including large artery atherosclerosis, small-vessel occlusion, cardioembolism, and stroke of other or undetermined cause. Results - Particulate matter <10 μm and SO2 concentrations were independently associated with an increased risk of cardioembolic stroke, as compared with large artery atherosclerosis and noncardioembolic stroke. In stratified analyses, the proportion of cases of cardioembolic stroke was positively correlated with the particulate matter <10 μm, NO2, and SO2 quintiles. Moreover, seasonal and geographic factors were related to an increased proportion of cardioembolic stroke, which may be attributed to the high levels of air pollution. Conclusions - Our findings suggest that the short-term exposure to air pollutants is associated with cardioembolic stroke, and greater care should be taken for those susceptible to cerebral embolism during peak pollution periods. Public and environmental health policies to reduce air pollution could help slow down global increasing trends of cardioembolic stroke.

Original languageEnglish
Pages (from-to)17-23
Number of pages7
JournalStroke
Volume48
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Air Pollution
Embolism
Stroke
Particulate Matter
Air Pollutants
Atherosclerosis
Arteries
Environmental Policy
Intracranial Embolism
Nitrogen Dioxide
Sulfur Dioxide
Geography
Environmental Health
Ozone
Carbon Monoxide
Health Policy
Registries

Keywords

  • air pollution
  • arrhythmias, cardiac
  • embolism
  • particulate matter
  • stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialised Nursing

Cite this

Chung, J. W., Bang, O. Y., Ahn, K., Park, S. S., Park, T. H., Kim, J. G., ... Bae, H. J. (2017). Air pollution is associated with ischemic stroke via cardiogenic embolism. Stroke, 48(1), 17-23. https://doi.org/10.1161/STROKEAHA.116.015428

Air pollution is associated with ischemic stroke via cardiogenic embolism. / Chung, Jong Won; Bang, Oh Young; Ahn, Kangmo; Park, Sang Soon; Park, Tai Hwan; Kim, Jae Guk; Ko, Youngchai; Lee, Soo Joo; Lee, Kyung Bok; Lee, Jun; Kang, Kyusik; Park, Jong Moo; Cho, Yong Jin; Hong, Keun Sik; Nah, Hyun Wook; Kim, Dae Hyun; Cha, Jae Kwan; Ryu, Wi Sun; Kim, Dong Eog; Kim, Joon Tae; Choi, Jay Chol; Oh, Mi Sun; Yu, Kyung Ho; Lee, Byung Chul; Lee, Ji Sung; Lee, Juneyoung; Park, Hong Kyun; Kim, Beom Joon; Han, Moon Ku; Bae, Hee Joon.

In: Stroke, Vol. 48, No. 1, 01.01.2017, p. 17-23.

Research output: Contribution to journalArticle

Chung, JW, Bang, OY, Ahn, K, Park, SS, Park, TH, Kim, JG, Ko, Y, Lee, SJ, Lee, KB, Lee, J, Kang, K, Park, JM, Cho, YJ, Hong, KS, Nah, HW, Kim, DH, Cha, JK, Ryu, WS, Kim, DE, Kim, JT, Choi, JC, Oh, MS, Yu, KH, Lee, BC, Lee, JS, Lee, J, Park, HK, Kim, BJ, Han, MK & Bae, HJ 2017, 'Air pollution is associated with ischemic stroke via cardiogenic embolism', Stroke, vol. 48, no. 1, pp. 17-23. https://doi.org/10.1161/STROKEAHA.116.015428
Chung JW, Bang OY, Ahn K, Park SS, Park TH, Kim JG et al. Air pollution is associated with ischemic stroke via cardiogenic embolism. Stroke. 2017 Jan 1;48(1):17-23. https://doi.org/10.1161/STROKEAHA.116.015428
Chung, Jong Won ; Bang, Oh Young ; Ahn, Kangmo ; Park, Sang Soon ; Park, Tai Hwan ; Kim, Jae Guk ; Ko, Youngchai ; Lee, Soo Joo ; Lee, Kyung Bok ; Lee, Jun ; Kang, Kyusik ; Park, Jong Moo ; Cho, Yong Jin ; Hong, Keun Sik ; Nah, Hyun Wook ; Kim, Dae Hyun ; Cha, Jae Kwan ; Ryu, Wi Sun ; Kim, Dong Eog ; Kim, Joon Tae ; Choi, Jay Chol ; Oh, Mi Sun ; Yu, Kyung Ho ; Lee, Byung Chul ; Lee, Ji Sung ; Lee, Juneyoung ; Park, Hong Kyun ; Kim, Beom Joon ; Han, Moon Ku ; Bae, Hee Joon. / Air pollution is associated with ischemic stroke via cardiogenic embolism. In: Stroke. 2017 ; Vol. 48, No. 1. pp. 17-23.
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AU - Bang, Oh Young

AU - Ahn, Kangmo

AU - Park, Sang Soon

AU - Park, Tai Hwan

AU - Kim, Jae Guk

AU - Ko, Youngchai

AU - Lee, Soo Joo

AU - Lee, Kyung Bok

AU - Lee, Jun

AU - Kang, Kyusik

AU - Park, Jong Moo

AU - Cho, Yong Jin

AU - Hong, Keun Sik

AU - Nah, Hyun Wook

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