TY - JOUR
T1 - Interactive effects of ambient fine particulate matter and ozone on typical blood coagulation parameters among patients with ischemic heart disease
AU - Chen, Juan
AU - You, Yu
AU - Zhang, Weidong
AU - Lei, Jian
AU - Li, Yulin
AU - Du, Jie
AU - Wu, Shaowei
N1 - Publisher Copyright:
© Elsevier Ltd
PY - 2025/7/15
Y1 - 2025/7/15
N2 - Background: The evidence for the interactive effects of long-term exposure to ambient fine particulate matter (PM2.5) and ozone (O3) with typical coagulation parameters which are widely used in clinical practices is limited. Methods: Data on basic information and typical coagulation parameters from 40,338 ischemic heart disease (IHD) patients with their first admission records between January 1, 2018 and May 31, 2019 were obtained from Anzhen Hospital, Beijing. Multivariate linear regression model and stratified analysis were used to evaluate separate and interactive effects of annual PM2.5 and maximum daily 8-h average (MDA8) O3 exposures on typical coagulation parameters. Results: We found that both long-term PM2.5 and MDA8 O3 exposures were associated with increases in prothrombin time and international normalized ratio (INR), and decreases in prothrombin activity (PTA), activated partial thromboplastin time (APTT), and D-Dimer. The effect estimates of both PM2.5 and MDA8 O3 on PTA, INR, and APTT were generally stronger at higher percentiles of co-pollutant strata (all Pdifference<0.05). For example, the percent changes in PTA associated with per 10 μg/m3 increase in PM2.5 were −0.68 % (95 %CI: −0.97 %, −0.38 %), −1.04 % (95 %CI: −1.30 %, −0.78 %) and −1.36 % (95 %CI: −1.80 %, −0.91 %) in the low (≤25 %), medium (25 %–75 %) and high (>75 %) MDA8 O3 strata, respectively; and the percent changes in PTA associated with per 10 μg/m3 increase in MDA8 O3 were −1.63 % (95 %CI: −1.96 %, −1.30 %), −1.67 % (95 %CI: −2.03 %, −1.30 %) and −2.30 % (95 %CI: −2.78 %, −1.82 %) in the low, medium and high PM2.5 strata, respectively. Conclusions: Our study provides novel evidence that long-term PM2.5 and O3 exposures synergistically impair the function of coagulation, which may lead to the adverse prognosis in IHD patients, highlighting the advantage of implementing integrated management approaches for both air pollutants.
AB - Background: The evidence for the interactive effects of long-term exposure to ambient fine particulate matter (PM2.5) and ozone (O3) with typical coagulation parameters which are widely used in clinical practices is limited. Methods: Data on basic information and typical coagulation parameters from 40,338 ischemic heart disease (IHD) patients with their first admission records between January 1, 2018 and May 31, 2019 were obtained from Anzhen Hospital, Beijing. Multivariate linear regression model and stratified analysis were used to evaluate separate and interactive effects of annual PM2.5 and maximum daily 8-h average (MDA8) O3 exposures on typical coagulation parameters. Results: We found that both long-term PM2.5 and MDA8 O3 exposures were associated with increases in prothrombin time and international normalized ratio (INR), and decreases in prothrombin activity (PTA), activated partial thromboplastin time (APTT), and D-Dimer. The effect estimates of both PM2.5 and MDA8 O3 on PTA, INR, and APTT were generally stronger at higher percentiles of co-pollutant strata (all Pdifference<0.05). For example, the percent changes in PTA associated with per 10 μg/m3 increase in PM2.5 were −0.68 % (95 %CI: −0.97 %, −0.38 %), −1.04 % (95 %CI: −1.30 %, −0.78 %) and −1.36 % (95 %CI: −1.80 %, −0.91 %) in the low (≤25 %), medium (25 %–75 %) and high (>75 %) MDA8 O3 strata, respectively; and the percent changes in PTA associated with per 10 μg/m3 increase in MDA8 O3 were −1.63 % (95 %CI: −1.96 %, −1.30 %), −1.67 % (95 %CI: −2.03 %, −1.30 %) and −2.30 % (95 %CI: −2.78 %, −1.82 %) in the low, medium and high PM2.5 strata, respectively. Conclusions: Our study provides novel evidence that long-term PM2.5 and O3 exposures synergistically impair the function of coagulation, which may lead to the adverse prognosis in IHD patients, highlighting the advantage of implementing integrated management approaches for both air pollutants.
KW - Coagulation parameters
KW - Fine particulate matter
KW - Interactive effects
KW - Ischemic heart disease
KW - Ozone
UR - https://www.scopus.com/pages/publications/105003155204
U2 - 10.1016/j.atmosenv.2025.121253
DO - 10.1016/j.atmosenv.2025.121253
M3 - 文章
AN - SCOPUS:105003155204
SN - 1352-2310
VL - 353
JO - Atmospheric Environment
JF - Atmospheric Environment
M1 - 121253
ER -