Associations between ambient wood smoke and other particulate pollutants and biomarkers of systemic inflammation, coagulation and thrombosis in cardiac patients.
Increased particulate air pollution has been associated with both an increased risk of myocardial infarction (MI) and adverse changes in cardiac biomarkers. Up to 30% of ambient wintertime fine particles (PM2.5) in Rochester, NY are from wood burning. Our study examined associations between ambient levels of a marker of wood smoke (Delta-C) and other particulate air pollutants and biomarkers of inflammation, coagulation and thrombosis.



We measured blood concentrations of C-reactive protein (CRP), D-dimer, fibrinogen, P-selectin, platelet factor 4 (PF-4), von Willebrand factor (vWF), and myeloperoxidase (MPO) of 135 patients undergoing cardiac catheterization during the winters of 2011-2013. We coupled these data with hourly ambient concentrations of Delta-C, black carbon (BC; marker of traffic pollution), and ultrafine (10-100nm; UFP), accumulation mode (100-500nm; AMP), and fine particles (<2.5µm; PM2.5). Using linear regression models, we estimated the change in each biomarker associated with increased pollutant concentrations at intervals between 1 and 96h preceding blood collection.



Each 0.13µg/m3increase in Delta-C concentration in the prior 12h was associated with a 0.91% increase in fibrinogen levels (95% CI=0.23%, 1.59%), but unexpectedly in the prior 48h, each 0.17µg/m3increase in Delta-C concentration was associated with a 2.75% decrease in MPO levels (95% CI=-5.13%,-0.37%). We did not see associations between Delta-C concentrations and any other biomarkers. Interquartile range (IQR) increases in PM2.5,BC, UFP, and AMP concentrations were generally associated with increased CRP and fibrinogen, but not PF4, D-dimer, vWF, or P-selectin.



In a population of cardiac patients, we noted adverse changes in fibrinogen associated with increased concentrations of a marker of wood smoke. Increases in PM2.5, BC, AMP, and UFP concentrations in the previous 96h were also associated with adverse changes in markers of systemic inflammation and coagulation, but not with markers of endothelial cell dysfunction or platelet activation.
Division of Pulmonary and Critical Care, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Daniel_Croft@URMC.Rochester.edu.
Daniel P
DP
Croft
Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Scott_Cameron@URMC.Rochester.edu.
Scott J
SJ
Cameron
Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Craig_Morrell@URMC.Rochester.edu.
Craig N
CN
Morrell
Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: charles_lowenstein@urmc.rochester.edu.
Charles J
CJ
Lowenstein
Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Fred_Ling@URMC.Rochester.edu.
Frederick
F
Ling
Division of Cardiology, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Wojciech_Zareba@URMC.Rochester.edu.
Wojciech
W
Zareba
Institute for a Sustainable Environment, and Center for Air Resources Engineering and Science, Clarkson University, Box 5708, Potsdam, NY 13699-5708, USA; Department of Public Health Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: phopke@clarkson.edu.
Philip K
PK
Hopke
Division of Pulmonary and Critical Care, Department of Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Mark_Utell@URMC.Rochester.edu.
Mark J
MJ
Utell
Department of Biostatistics and Computational Biology, University of Rochester, University of Rochester Medical Center, Saunders Research Building, 265 Crittenden Blvd., Box 630, Rochester, NY 14642, USA. Electronic address: Sally_Thurston@URMC.Rochester.edu.
Sally W
SW
Thurston
Department of Public Health Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: Kelly_Thevenet-morrison@URMC.Rochester.edu.
Kelly
K
Thevenet-Morrison
Department of Public Health Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: kristin.evans@truvenhealth.com.
Kristin A
KA
Evans
Department of Public Health Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: David_Chalupa@URMC.Rochester.edu.
David
D
Chalupa
Department of Public Health Sciences, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Rochester, NY, USA. Electronic address: David_Rich@URMC.Rochester.edu.
David Q
DQ
Rich
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D001777:Blood Coagulation / Q000187:drug effects*; D002097:C-Reactive Protein / Q000032:analysis; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006331:Heart Diseases / Q000150:complications*; D006801:Humans; D007249:Inflammation / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009518:New York; D019007:P-Selectin / Q000032:analysis; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D009195:Peroxidase / Q000032:analysis; D012906:Smoke / Q000009:adverse effects* / Q000032:analysis; D013927:Thrombosis / Q000139:chemically induced*; D014934:Wood; D014841:von Willebrand Factor / Q000032:analysis
D015415:Biomarkers; D019007:P-Selectin; D052638:Particulate Matter; D012906:Smoke; D014841:von Willebrand Factor; D005340:Fibrinogen; D002097:C-Reactive Protein; D009195:Peroxidase
Air pollution; Delta-C; Fibrinogen; Inflammation; Wood smoke