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Diesel Exhaust Has Ischemic and Thrombotic Effects

Study of male myocardial infarction survivors suggests pollution may contribute to adverse events

WEDNESDAY, Sept. 12 (HealthDay News) -- In men with stable heart disease, even limited exposure to diesel exhaust fosters myocardial ischemia and inhibits endogenous fibrinolytic capacity, according to a report in the Sept. 13 issue of the New England Journal of Medicine.

Nicholas L. Mills, M.D., of Edinburgh University in the United Kingdom, and colleagues randomly assigned 20 male myocardial infarction survivors to be exposed to either one hour of diluted diesel exhaust or filtered air during one hour of rest and moderate exercise.

Although heart rate increased in both groups during exercise and all subjects experienced exercise-induced ST-segment depression, the researchers found that the diesel-exhaust group had a greater increase in ischemic burden (-22 millivolt seconds versus -8 millivolt seconds). They also found that diesel exhaust prompted an acute release of endothelial tissue plasminogen activator.

"Environmental health policy interventions targeting reductions in urban air pollution should be considered in order to decrease the risk of adverse cardiovascular events," the authors conclude.

"Considering the unequivocal benefit of habitual exercise, including its established role in decreasing the risk that isolated episodes of exertion may trigger the onset of an acute cardiovascular event, the risk-benefit ratio may be optimized if people exercise away from traffic when possible," states the author of an accompanying editorial.

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