Abstract：
To determine the long-term cardiovascular disease risk of astronauts with spaceflight exposure compared with a well-matched cohort.
National Aeronautics and Space Administration (NASA) astronauts are selected into their profession based upon education, unique skills, and health and are exposed to cardiovascular disease risk factors during spaceflight. The Cooper Center Longitudinal Study (CCLS) is a generally healthy cohort from a preventive medicine clinic in Dallas, Texas. Using a matched cohort design, astronauts who were selected beginning April 1, 1959, (and each subsequent selection class through 2009) and exposed to spaceflight were matched to CCLS participants who met astronaut selection criteria; 1514 CCLS participants matched to 303 astronauts in a 5-to-1 ratio on sex, date of birth, and age. The outcome of cardiovascular mortality through December 31, 2016, was determined by death certificate or National Death Index.
There were 11 deaths caused by cardiovascular disease (CVD) among astronauts and 46 among CCLS participants. There was no evidence of increased mortality risk in astronauts (hazard ratio [HR]=1.10; 95% confidence interval [CI], 0.50 to 2.45) with adjustment for baseline cardiovascular covariates. However, the secondary outcome of CVD events showed an increased adjusted risk in astronauts (HR=2.41; 95% CI, 1.26 to 4.63).
No increased risk of CVD mortality was observed in astronauts with spaceflight exposure compared with a well-matched cohort, but there was evidence of increased total CVD events. Given that the duration of spaceflight will increase, particularly on missions to Mars, continued surveillance and mitigation of CVD risk is needed to ensure the safety of those who venture into space.
National Aeronautics and Space Administration (NASA) astronauts are selected into their profession based upon education, unique skills, and health and are exposed to cardiovascular disease risk factors during spaceflight. The Cooper Center Longitudinal Study (CCLS) is a generally healthy cohort from a preventive medicine clinic in Dallas, Texas. Using a matched cohort design, astronauts who were selected beginning April 1, 1959, (and each subsequent selection class through 2009) and exposed to spaceflight were matched to CCLS participants who met astronaut selection criteria; 1514 CCLS participants matched to 303 astronauts in a 5-to-1 ratio on sex, date of birth, and age. The outcome of cardiovascular mortality through December 31, 2016, was determined by death certificate or National Death Index.
There were 11 deaths caused by cardiovascular disease (CVD) among astronauts and 46 among CCLS participants. There was no evidence of increased mortality risk in astronauts (hazard ratio [HR]=1.10; 95% confidence interval [CI], 0.50 to 2.45) with adjustment for baseline cardiovascular covariates. However, the secondary outcome of CVD events showed an increased adjusted risk in astronauts (HR=2.41; 95% CI, 1.26 to 4.63).
No increased risk of CVD mortality was observed in astronauts with spaceflight exposure compared with a well-matched cohort, but there was evidence of increased total CVD events. Given that the duration of spaceflight will increase, particularly on missions to Mars, continued surveillance and mitigation of CVD risk is needed to ensure the safety of those who venture into space.
摘要：
与匹配良好的队列相比，确定宇航员接受太空飞行暴露的长期心血管疾病风险。
美国国家航空航天局（NASA）的宇航员根据教育被选入他们的职业，独特的技能，和健康，并在太空飞行期间暴露于心血管疾病的危险因素。库珀中心纵向研究（CCLS）是达拉斯预防医学诊所的总体健康队列，德克萨斯州。使用匹配的队列设计，从1959年4月1日（以及随后的每个选拔班直到2009年）开始选拔并暴露于太空飞行的宇航员与符合宇航员选择标准的CCLS参与者进行匹配；1514名CCLS参与者与303名宇航员的性别比例为5：1，出生日期,和年龄。截至2016年12月31日的心血管死亡率结果由死亡证明或国家死亡指数确定。
宇航员中有11人死于心血管疾病（CVD），CCLS参与者中有46人死于心血管疾病（CVD）。没有证据表明宇航员的死亡风险增加（危险比[HR]=1.10；95％置信区间[CI]，0.50至2.45），并调整基线心血管协变量。然而,心血管事件的次要结局显示宇航员的校正风险增加(HR=2.41;95%CI,1.26~4.63).
与匹配良好的队列相比，在接受太空飞行的宇航员中没有观察到CVD死亡率的风险增加。但有证据表明总CVD事件增加.鉴于太空飞行的持续时间将会增加，特别是在火星任务中，需要继续监测和缓解CVD风险，以确保那些冒险进入太空的人的安全。
美国国家航空航天局（NASA）的宇航员根据教育被选入他们的职业，独特的技能，和健康，并在太空飞行期间暴露于心血管疾病的危险因素。库珀中心纵向研究（CCLS）是达拉斯预防医学诊所的总体健康队列，德克萨斯州。使用匹配的队列设计，从1959年4月1日（以及随后的每个选拔班直到2009年）开始选拔并暴露于太空飞行的宇航员与符合宇航员选择标准的CCLS参与者进行匹配；1514名CCLS参与者与303名宇航员的性别比例为5：1，出生日期,和年龄。截至2016年12月31日的心血管死亡率结果由死亡证明或国家死亡指数确定。
宇航员中有11人死于心血管疾病（CVD），CCLS参与者中有46人死于心血管疾病（CVD）。没有证据表明宇航员的死亡风险增加（危险比[HR]=1.10；95％置信区间[CI]，0.50至2.45），并调整基线心血管协变量。然而,心血管事件的次要结局显示宇航员的校正风险增加(HR=2.41;95%CI,1.26~4.63).
与匹配良好的队列相比，在接受太空飞行的宇航员中没有观察到CVD死亡率的风险增加。但有证据表明总CVD事件增加.鉴于太空飞行的持续时间将会增加，特别是在火星任务中，需要继续监测和缓解CVD风险，以确保那些冒险进入太空的人的安全。
