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

University of Edinburgh1 enrolled

Overview

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.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Angina Pectoris Coronary Heart Disease

Eligibility

Sex: ALL

Medical Language ↔ Plain English

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

Locations (2)

University of Edinburgh

Edinburgh, Midlothian, United Kingdom

Imperial College

London, United Kingdom

Outcomes

Primary Outcomes

Symptoms of angina pectoris - assessed by symptom diary and reliever medication usage

Time frame: Throughout study period

Secondary Outcomes

Myocardial ischaemic burden - assessed using 12-lead continuous Holter ECG monitoring

Time frame: Throughout study period

Time to 1mm ST segment depression during standard BRUCE exercise stress testing

Time frame: At the end of the study period

Total exercise capacity - measured using GPS tracking of activity completed

Time frame: Throughout study period

Exercise capacity - determined by standard BRUCE exercise stress testing

Time frame: Immediately after study period

Ambulatory blood pressure

Time frame: Throughout study period

Biochemical evidence of myocardial ischaemia - highly sensitive troponin, ischaemically modified albumin and fatty acid binding protein

Time frame: Before and after study period

Data from ClinicalTrials.gov

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