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Air pollution and inflammatory response in myocardial infraction survivors : gene-environment-interactions in high-risk group

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Ambient air pollution has been associated with an increased risk of hospital admission and mortality in potentially susceptible subpopulations, including myocardial infarction (MI) survivors. The multicenter epidemiological study described in this report was set up to study the role of air pollution in eliciting inflammation in MI survivors in six European cities, Helsinki, Stockholm, Augsburg, Rome, Barcelona, Athens. Outcomes of interest are plasma concentrations of the pro-inflammatory cytokine interleukin 6 (IL-6) and the acute phase proteins fibrinogen and C-reactive protein (CRP). In addition, the study was designed to assess the role of candidate gene polymorphisms hypothesized to lead to a modification of the short-term effects of ambient air pollution. A total of 1,003 MI survivors were recruited and assessed with at least 2 repeated clinic visits without any signs of infections. Three days prior to the visit a total of 5,813 blood samples were collected equivalent to an average of 5.8 repeated clinic visits per subject (97% of the scheduled 6 repeated visits). Subjects across the 6 cities varied with respect to risk factor profiles. Most of the subjects were non-smokers, but light smokers were included in Rome, Barcelona and Athens. Substantial inter- and intra-individual variability was observed for IL-6, fibrinogen and CRP. The study will permit assessing the role of cardiovascular disease risk factors, including ambient air pollution and genetic polymorphisms in candidate genes, in determining the inter- and the intra-individual variability in plasma IL-6, CRP and fibrinogen concentrations in MI survivors.

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