Objective To examine the effects of exposure to air pollutants on the peripheral blood cells, myocardial enzymes, and inflammatory response of patients with acute coronary syndrome (ACS), and to identify ACS risk factors.
Methods Subjects included patients with ACS in Shanghai, China, who were admitted to a grade-three hospital through Cardiac Intervention Green Channel in 2008-2009. They were tested for the following biochemical indicators: general biochemical indicators, such as cholesterol, triglycerides, and low-density lipoprotein cholesterol; peripheral blood cells and inflammatory indicators, such as white blood cell count, lymphocyte percentage, and high-sensitivity C-reactive protein; myocardial injury markers: creatine kinase, troponin, and hydroxyproline glycoprotein. Atmospheric pollutants coarse particulate (PM10), sulfur dioxide, and nitrogen dioxide data and meteorological data were also collected. The associations between air pollutants and related risk factors of ACS were analyzed by Spearman correlation analysis.
Results The lymphocyte percentage was closely associated with the recorded PM10 in the Spearman correlation analysis (r=0.235, P< 0.05). The results of multiple stepwise regression analysis showed when using lymphocyte percentages in ACS patients as a dependent variable, PM10 (P=0.011) and gender (P=0.020) were incorporated in the model.
Conclusion Exposure to high concentrations of PM10 can lead to changes in patients' lymphocyte percentages and affect their immune system function. These findings indicate that PM10 is likely to be a risk factor for ACS.
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