The association of chronic air pollutants with coronary artery spasm, vasospastic angina, and endothelial dysfunction

Byoung Geol Choi, Jiwon Lee, Suhng Wook Kim, Min Woo Lee, Man Jong Baek, Yang Gi Ryu, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo & 2 others Dong Joo Oh, Seung-Woon Rha

Research output: Contribution to journalArticle

Abstract

Background We evaluated the effect of chronic exposure to air pollutants (APs) on coronary endothelial function and significant coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACH) provocation test. Patients and methods A total of 6430 patients with typical or atypical chest pain who underwent intracoronary ACH provocation test were enrolled. We obtained data on APs from the Korean National Institute of Environmental Research (http://www.nier.go.kr/). APs are largely divided into two types: Particulate matter with aerodynamic diameter of less than or equal to 10 μm in size (PM 10) and gaseous pollutants such as nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone. The primary endpoint is the incidence of significant CAS and its associated parameters during ACH provocation test. Results The incidence of CAS was positively correlated with an exposure duration of PM 10, whereas nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone were shown to be unrelated to CAS. During the ACH provocation test, as PM 10 increased, the frequency of CAS was increased, and the incidence of transient ST-segment elevation was also increased. There was a trend toward higher incidence of spontaneous spasm as PM 10 increased. The mean exposure level of PM 10 was 51.3±25.4 μg/m 3. The CAS risk increased by 4% when the level of PM 10 increased by 20 μg/m 3 by an adjusted Cox regression analysis. Conclusion CAS incidence is closely related to exposure to PMs but not to gaseous pollutants. Particularly, higher exposure concentrations and longer exposure duration of PM 10 increased the risk of CAS. These important findings provide a plausible mechanism that links air pollution to vasospastic angina and provide new insights into environmental factors.

Original languageEnglish
Pages (from-to)336-343
Number of pages8
JournalCoronary Artery Disease
Volume29
Issue number4
DOIs
Publication statusPublished - 2018 Jan 1

Fingerprint

Air Pollutants
Spasm
Coronary Vessels
Acetylcholine
Incidence
Nitrogen Dioxide
Sulfur Dioxide
Ozone
Carbon Monoxide
Particulate Matter
Air Pollution
Chest Pain
Regression Analysis

Keywords

  • air pollution
  • angina
  • coronary artery disease
  • coronary artery spasm

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The association of chronic air pollutants with coronary artery spasm, vasospastic angina, and endothelial dysfunction. / Choi, Byoung Geol; Lee, Jiwon; Kim, Suhng Wook; Lee, Min Woo; Baek, Man Jong; Ryu, Yang Gi; Choi, Se Yeon; Byun, Jae Kyeong; Mashaly, Ahmed; Park, Yoonjee; Jang, Won Young; Kim, Woohyeun; Choi, Jah Yeon; Park, Eun Jin; Na, Jin Oh; Choi, Cheol Ung; Lim, Hong Euy; Kim, Eung Ju; Park, Chang Gyu; Seo, Hong Seog; Oh, Dong Joo; Rha, Seung-Woon.

In: Coronary Artery Disease, Vol. 29, No. 4, 01.01.2018, p. 336-343.

Research output: Contribution to journalArticle

Choi, Byoung Geol ; Lee, Jiwon ; Kim, Suhng Wook ; Lee, Min Woo ; Baek, Man Jong ; Ryu, Yang Gi ; Choi, Se Yeon ; Byun, Jae Kyeong ; Mashaly, Ahmed ; Park, Yoonjee ; Jang, Won Young ; Kim, Woohyeun ; Choi, Jah Yeon ; Park, Eun Jin ; Na, Jin Oh ; Choi, Cheol Ung ; Lim, Hong Euy ; Kim, Eung Ju ; Park, Chang Gyu ; Seo, Hong Seog ; Oh, Dong Joo ; Rha, Seung-Woon. / The association of chronic air pollutants with coronary artery spasm, vasospastic angina, and endothelial dysfunction. In: Coronary Artery Disease. 2018 ; Vol. 29, No. 4. pp. 336-343.
@article{9019e569001c4c8ca7327e0437411d86,
title = "The association of chronic air pollutants with coronary artery spasm, vasospastic angina, and endothelial dysfunction",
abstract = "Background We evaluated the effect of chronic exposure to air pollutants (APs) on coronary endothelial function and significant coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACH) provocation test. Patients and methods A total of 6430 patients with typical or atypical chest pain who underwent intracoronary ACH provocation test were enrolled. We obtained data on APs from the Korean National Institute of Environmental Research (http://www.nier.go.kr/). APs are largely divided into two types: Particulate matter with aerodynamic diameter of less than or equal to 10 μm in size (PM 10) and gaseous pollutants such as nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone. The primary endpoint is the incidence of significant CAS and its associated parameters during ACH provocation test. Results The incidence of CAS was positively correlated with an exposure duration of PM 10, whereas nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone were shown to be unrelated to CAS. During the ACH provocation test, as PM 10 increased, the frequency of CAS was increased, and the incidence of transient ST-segment elevation was also increased. There was a trend toward higher incidence of spontaneous spasm as PM 10 increased. The mean exposure level of PM 10 was 51.3±25.4 μg/m 3. The CAS risk increased by 4{\%} when the level of PM 10 increased by 20 μg/m 3 by an adjusted Cox regression analysis. Conclusion CAS incidence is closely related to exposure to PMs but not to gaseous pollutants. Particularly, higher exposure concentrations and longer exposure duration of PM 10 increased the risk of CAS. These important findings provide a plausible mechanism that links air pollution to vasospastic angina and provide new insights into environmental factors.",
keywords = "air pollution, angina, coronary artery disease, coronary artery spasm",
author = "Choi, {Byoung Geol} and Jiwon Lee and Kim, {Suhng Wook} and Lee, {Min Woo} and Baek, {Man Jong} and Ryu, {Yang Gi} and Choi, {Se Yeon} and Byun, {Jae Kyeong} and Ahmed Mashaly and Yoonjee Park and Jang, {Won Young} and Woohyeun Kim and Choi, {Jah Yeon} and Park, {Eun Jin} and Na, {Jin Oh} and Choi, {Cheol Ung} and Lim, {Hong Euy} and Kim, {Eung Ju} and Park, {Chang Gyu} and Seo, {Hong Seog} and Oh, {Dong Joo} and Seung-Woon Rha",
year = "2018",
month = "1",
day = "1",
doi = "10.1097/MCA.0000000000000603",
language = "English",
volume = "29",
pages = "336--343",
journal = "Coronary Artery Disease",
issn = "0954-6928",
publisher = "Lippincott Williams and Wilkins",
number = "4",

}

TY - JOUR

T1 - The association of chronic air pollutants with coronary artery spasm, vasospastic angina, and endothelial dysfunction

AU - Choi, Byoung Geol

AU - Lee, Jiwon

AU - Kim, Suhng Wook

AU - Lee, Min Woo

AU - Baek, Man Jong

AU - Ryu, Yang Gi

AU - Choi, Se Yeon

AU - Byun, Jae Kyeong

AU - Mashaly, Ahmed

AU - Park, Yoonjee

AU - Jang, Won Young

AU - Kim, Woohyeun

AU - Choi, Jah Yeon

AU - Park, Eun Jin

AU - Na, Jin Oh

AU - Choi, Cheol Ung

AU - Lim, Hong Euy

AU - Kim, Eung Ju

AU - Park, Chang Gyu

AU - Seo, Hong Seog

AU - Oh, Dong Joo

AU - Rha, Seung-Woon

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Background We evaluated the effect of chronic exposure to air pollutants (APs) on coronary endothelial function and significant coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACH) provocation test. Patients and methods A total of 6430 patients with typical or atypical chest pain who underwent intracoronary ACH provocation test were enrolled. We obtained data on APs from the Korean National Institute of Environmental Research (http://www.nier.go.kr/). APs are largely divided into two types: Particulate matter with aerodynamic diameter of less than or equal to 10 μm in size (PM 10) and gaseous pollutants such as nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone. The primary endpoint is the incidence of significant CAS and its associated parameters during ACH provocation test. Results The incidence of CAS was positively correlated with an exposure duration of PM 10, whereas nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone were shown to be unrelated to CAS. During the ACH provocation test, as PM 10 increased, the frequency of CAS was increased, and the incidence of transient ST-segment elevation was also increased. There was a trend toward higher incidence of spontaneous spasm as PM 10 increased. The mean exposure level of PM 10 was 51.3±25.4 μg/m 3. The CAS risk increased by 4% when the level of PM 10 increased by 20 μg/m 3 by an adjusted Cox regression analysis. Conclusion CAS incidence is closely related to exposure to PMs but not to gaseous pollutants. Particularly, higher exposure concentrations and longer exposure duration of PM 10 increased the risk of CAS. These important findings provide a plausible mechanism that links air pollution to vasospastic angina and provide new insights into environmental factors.

AB - Background We evaluated the effect of chronic exposure to air pollutants (APs) on coronary endothelial function and significant coronary artery spasm (CAS) as assessed by intracoronary acetylcholine (ACH) provocation test. Patients and methods A total of 6430 patients with typical or atypical chest pain who underwent intracoronary ACH provocation test were enrolled. We obtained data on APs from the Korean National Institute of Environmental Research (http://www.nier.go.kr/). APs are largely divided into two types: Particulate matter with aerodynamic diameter of less than or equal to 10 μm in size (PM 10) and gaseous pollutants such as nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone. The primary endpoint is the incidence of significant CAS and its associated parameters during ACH provocation test. Results The incidence of CAS was positively correlated with an exposure duration of PM 10, whereas nitrogen dioxide, sulfur dioxide, carbon monoxide, and ozone were shown to be unrelated to CAS. During the ACH provocation test, as PM 10 increased, the frequency of CAS was increased, and the incidence of transient ST-segment elevation was also increased. There was a trend toward higher incidence of spontaneous spasm as PM 10 increased. The mean exposure level of PM 10 was 51.3±25.4 μg/m 3. The CAS risk increased by 4% when the level of PM 10 increased by 20 μg/m 3 by an adjusted Cox regression analysis. Conclusion CAS incidence is closely related to exposure to PMs but not to gaseous pollutants. Particularly, higher exposure concentrations and longer exposure duration of PM 10 increased the risk of CAS. These important findings provide a plausible mechanism that links air pollution to vasospastic angina and provide new insights into environmental factors.

KW - air pollution

KW - angina

KW - coronary artery disease

KW - coronary artery spasm

UR - http://www.scopus.com/inward/record.url?scp=85046552151&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85046552151&partnerID=8YFLogxK

U2 - 10.1097/MCA.0000000000000603

DO - 10.1097/MCA.0000000000000603

M3 - Article

VL - 29

SP - 336

EP - 343

JO - Coronary Artery Disease

JF - Coronary Artery Disease

SN - 0954-6928

IS - 4

ER -