研究背景與目標：包括腦血管疾病在內，心血管疾病是當前全球的主要死因，其所導致的死亡數皆較其他疾病原因來得高。過往的流行病學研究發現，一般環境下的一氧化碳空氣汙染暴露可能與須接受入院治療的心血管疾病之發作有關。然而，研究結果並不一致，且所觀察到的風險可能會因疾病的不同而有所差異。因此，本研究的目標是執行一項系統性文獻回顧與統合分析研究以評估及量化一般環境下的一氧化碳汙染暴露與心血管疾病發作之相關性。

研究材料與方法：本研究使用Embase及PubMed學術資料庫篩選出2020年4月前已發表之一氧化碳暴露與心血管疾病發作的相關性研究進行系統性文獻回顧。對於具有顯著異質性的研究，採用隨機效應模型來估算每增加1毫克/立方公尺(mg/m^3)的一氧化碳暴露濃度可能導致的心血管疾病發作相對風險(relative risk, RR)及其95%信賴區間(confidence interval, CI)；對於無顯著異質性的研究則採用固定效應模型進行估算。

研究結果：本研究所執行的統合分析一共納入37篇研究 ，結果 發現，一般環境下的一氧化碳汙染暴露與心血管疾病發作之間具有統計上的顯著相關性(RR = 1.024; 95% CI: 1.017–1.031). 從個別疾病來看，一氧化碳暴露與腦中風(RR = 1.033; 95% CI: 1.004–1.062)、心律不整(RR = 1.018; 95% CI: 1.006–1.030)、缺血性心臟病(RR = 1.017; 95% CI : 1.006–1.028)、心衰竭(RR = 1.025; 95% CI: 1.017–1.033)等疾病有統計上的顯著相關性。

研究結論：本研究發現一般環境下的一氧化碳空氣汙染暴露與心血管疾病，包括腦中風、心律不整、缺血性心臟病與心衰竭的風險增加有關

Background and Purpose: Cardiovascular diseases (CVDs), including cerebrovascular diseases, are the leading cause of death globally, and more people die from CVDs than from any other cause. Many epidemiological studies have demonstrated the association between carbon monoxide (CO) in the ambient air and the occurrence of CVDs in terms of hospital admissions and mortality. However, the findings are not consistent, and the risk may vary across diseases. The purpose of this study was to assess and quantify the associations between CO exposure and the occurrence of various CVDs.

Methods: We conducted a systematic review of the literature using Embase and PubMed to identify studies reporting quantitative data on the association between CO and CVDs that were published before April 2020. Relative risks (RRs) and their 95% confidence intervals (CIs) of various CVDs associated with each 1 mg/m^3 increase in CO were calculated using a random-effect model (for studies with significant heterogeneity) or a fixed-effect model (for studies without significant heterogeneity).

Results: A total of 37 studies were included in this meta-analysis. Positive asssociations between CO and CVDs as a whole (RR = 1.024; 95% CI: 1.017–1.031), stroke (RR = 1.033; 95% CI: 1.004–1.062), arrhythmia (RR = 1.018; 95% CI: 1.006–1.030), ischemic heart disease (RR = 1.017; 95% CI: 1.006–1.028), and heart failure (RR = 1.025; 95% CI: 1.017–1.033) were obtained in this study.

Conclusions: Our analysis found that CO in the ambient air was associated with increases in the risks of CVDs as a whole, stroke, arrhythmia, ischemic heart disease, and heart failure.

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