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(Circulation. 2006;114:2429.)
© 2006 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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ISCHEMIC HEART DISEASE EVENTS TRIGGERED BY SHORT-TERM EXPOSURE TO FINE PARTICULATE AIR POLLUTION, by Pope et al. |
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Long-term exposure to particulate matter has been linked to chronic lung injury, vascular inflammation, and atherosclerosis in animals and increased risk of pulmonary disease, ischemic heart disease, and death in humans. Short-term exposure to particulate matter has been reported to alter vascular and cardiac function and to trigger myocardial infarction and stroke in humans. The study by Pope et al, reported in this issue of Circulation, took advantage of an almost 13 000 patient catheterization registry and daily community-based monitoring of particulate matter concentrations. The investigators observed that ambient fine particulate pollution was associated with a 45% increased risk of acute coronary syndromes. Furthermore, they report that individuals with catheterization-documented coronary artery disease were particularly vulnerable to pollution. Because exposure to pollution is common in metropolitan settings, these findings may have important implications for public health and public policy debates about acceptable pollution levels. See p 2443.
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EXTENDING THE HORIZON IN CHRONIC HEART FAILURE: EFFECTS OF MULTIDISCIPLINARY, HOME-BASED INTERVENTION RELATIVE TO USUAL CARE, by Inglis et al. |
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Disease management programs are increasing in popularity, but little is known about their long-term impact on patient outcomes. Australian investigators previously conducted a randomized trial of a nurse-led, multidisciplinary, home-based intervention for elderly patients with heart failure and found that the intervention improved survival and reduced hospital admissions. The intervention consisted of no more than 6 months of support. Now Inglis and colleagues have examined the outcomes of these patients 7.5 to 10 years after first entering the study. Their question is whether the relatively brief intervention was able to change the trajectory of the disease in the participants over the
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