Interactive effects of ambient fine particulate matter and ozone on typical blood coagulation parameters among patients with ischemic heart disease

IF 4.2 2区环境科学与生态学 Q2 ENVIRONMENTAL SCIENCES

Atmospheric Environment Pub Date : 2025-04-17 DOI:10.1016/j.atmosenv.2025.121253

Juan Chen , Yu You , Weidong Zhang , Jian Lei , Yulin Li , Jie Du , Shaowei Wu

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引用次数: 0

Abstract

Background

The evidence for the interactive effects of long-term exposure to ambient fine particulate matter (PM_2.5) 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 PM_2.5 and maximum daily 8-h average (MDA8) O₃ exposures on typical coagulation parameters.

Results

We found that both long-term PM_2.5 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 PM_2.5 and MDA8 O₃ on PTA, INR, and APTT were generally stronger at higher percentiles of co-pollutant strata (all P_difference<0.05). For example, the percent changes in PTA associated with per 10 μg/m³ increase in PM_2.5 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 PM_2.5 strata, respectively.

Conclusions

Our study provides novel evidence that long-term PM_2.5 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.

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环境细颗粒物与臭氧对缺血性心脏病患者典型凝血参数的交互作用

长期暴露于具有典型凝血参数的环境细颗粒物（PM2.5）和臭氧（O3）的相互作用证据在临床实践中被广泛使用。方法收集2018年1月1日至2019年5月31日在北京安贞医院首次就诊的40338例缺血性心脏病（IHD）患者的基本信息和典型凝血参数。采用多元线性回归模型和分层分析，评价PM2.5年暴露量和最大日8 h平均值（MDA8） O3暴露量对典型凝血参数的单独影响和交互影响。结果我们发现，PM2.5和mda8o3长期暴露与凝血酶原时间和国际标准化比（INR）的增加以及凝血酶原活性（PTA）、活化的部分凝血活素时间（APTT）和d -二聚体的降低有关。PM2.5和mda8o3对PTA、INR和APTT的影响估计值在共污染物层的较高百分位数时普遍较强（均差异0.05）。例如，PM2.5每增加10 μg/m3， PTA的百分比变化分别为- 0.68% （95% CI: - 0.97%, - 0.38%）、- 1.04% （95% CI: - 1.30%, - 0.78%）和- 1.36% (95% CI: - 1.80%, - 0.91%)，分别为低（≤25%）、中（25% - 75%）和高（> 75%） MDA8 O3地层；PM2.5浓度每增加10 μg/m3， PTA的变化百分比分别为- 1.63% （95% CI: - 1.96%, - 1.30%）、- 1.67% （95% CI: - 2.03%, - 1.30%）和- 2.30% （95% CI: - 2.78%, - 1.82%）。结论我们的研究提供了新的证据，证明长期暴露于PM2.5和O3会协同损害凝血功能，从而可能导致IHD患者预后不良，突出了对这两种空气污染物实施综合管理的优势。

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来源期刊

Atmospheric Environment 环境科学-环境科学

CiteScore

9.40

自引率

8.00%

发文量

458

审稿时长

53 days

期刊介绍： Atmospheric Environment has an open access mirror journal Atmospheric Environment: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. Atmospheric Environment is the international journal for scientists in different disciplines related to atmospheric composition and its impacts. The journal publishes scientific articles with atmospheric relevance of emissions and depositions of gaseous and particulate compounds, chemical processes and physical effects in the atmosphere, as well as impacts of the changing atmospheric composition on human health, air quality, climate change, and ecosystems.