{
  "abstract": "Background Fine particulate matter (FPM) is a well-established contributor to atherothrombotic disease and ischemic stroke risk. While national trends suggest improvement, they may obscure important geographic disparities. This study evaluates temporal changes in the ischemic stroke burden attributable to FPM across the United States and all 50 states plus the District of Columbia from 1990 to 2021.Methods Data were obtained from the Global Burden of Disease 2021 study. Age-standardized attributable deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) per 100,000 population were analyzed with 95% uncertainty intervals. National and state-level estimates were assessed for 1990-2021. Absolute values for 2021, along with absolute and relative changes since 1990, were calculated. Annualized percent changes were estimated using linear regression.Results In 2021, FPM was associated with 50,085 ischemic stroke deaths in the United States (24,665-78,678), representing a 63% decrease from 1990. The age-standardized mortality rate declined by 80%, from 41.6 to 8.2 per 100,000. DALYs decreased by 59% (2.90 million to 1.20 million), with a 76% reduction in the age-standardized DALY rate. YLLs fell by 66%, while the corresponding rate declined by 80%. In contrast, total YLDs increased by 14%, though the age-standardized YLD rate decreased by 35%, suggesting improved survival with residual disability. Substantial state-level variation persisted, with the largest YLD rate reductions observed in Wyoming, Maine, and Vermont, and the smallest in Texas, Utah, and Nevada.Conclusions Despite substantial national reductions in mortality and overall burden of ischemic stroke attributable to FPM from 1990 to 2021, significant residual morbidity and geographic disparities remain. These findings highlight the continued need for stringent air quality policies and targeted interventions in high-burden regions.Disclosures A. Gajjar: None. T. Sorenson: None. C. Kung: None. A. Custozzo: None. H. Greene: None.Abstract P-012 Figure 1Age-specific FPM-attributable ischemic-stroke deaths and mortality rates in 2021 for ischemic stroke mortalityAbstract P-012 Figure 2State-level percent change in FPM-attributable stroke-related disability from 1990 to 2021",
  "authors": [
    {
      "affiliations": [
        "Neurosurgery, Albany Medical College, Albany, NY"
      ],
      "name": "A Gajjar"
    },
    {
      "affiliations": [
        "Neurosurgery, Albany Medical College, Albany, NY"
      ],
      "name": "T Sorenson"
    },
    {
      "affiliations": [
        "Neurosurgery, Albany Medical College, Albany, NY"
      ],
      "name": "C Kung"
    },
    {
      "affiliations": [
        "Neurosurgery, Albany Medical College, Albany, NY"
      ],
      "name": "A Custozzo"
    },
    {
      "affiliations": [
        "Neurosurgery, Albany Medical College, Albany, NY"
      ],
      "name": "H Greene"
    }
  ],
  "title": "P-012 Fine particulate matter’s impact on ischemic stroke in the United States: a 1990 to 2021 state-wide analysis across the United States",
  "uid": "a34c33f9-a343-5b54-ad1f-4cf41ea17c65"
}