Effects of Ambient Air Pollution Exposure in Patients With Stable Angina Pectoris During Normal Daily Activities

Effects of Ambient Air Pollution Exposure in Patients With Stable Angina Pectoris During Normal Daily Activities

The purpose of this study is to identify whether exposure to ambient levels of air pollution during normal daily activities has a functional impact on patients with coronary heart disease

Exposure to air pollution has been shown in epidemiological studies to be closely linked to cardiovascular morbidity and mortality. The exact components of air pollution that underlie the cardiovascular effects are not yet known, but combustion-derived particulate matter is suspected to be the major cause. In controlled exposure studies, we have recently demonstrated that exposure to diesel exhaust causes increased myocardial ischaemia with exercise in patients with asymptomatic coronary artery disease. The mechanism behind this effect is not yet understood, but we have shown that diesel exhaust exposure causes an acute impairment of two important and highly relevant aspects of vascular tone: vasomotor tone and endogenous fibrinolysis. In this study we propose to investigate the effects of exposure to ambient levels of air pollution on patients with stable, symptomatic angina pectoris, during their daily lives.

Inclusion Criteria:

• Documented coronary artery disease
• Symptoms of stable angina pectoris
• Positive BRUCE exercise stress test between 3 and 13 minutes

Exclusion Criteria:

• History of arrhythmia
• Severe 3 vessel coronary disease or left main stem stenosis that has not been revascularised
• Resting conduction abnormality
• Digoxin therapy
• Uncontrolled hypertension
• Renal or hepatic failure
• Unstable symptoms or acute coronary syndrome within 3 months