Abstract
Previously, we found short-term increases in ambient particulate matter (PM) air pollutant concentrations were associated with increased serum fibrinogen levels in patients with cardiac disease. We now studied whether high blood levels of omega-3 (ω-3) fatty acids blunted this fibrinogen response to increased PM concentrations in these same patients. Plasma fibrinogen and ω-3 fatty acid levels (% of total identified fatty acids) were measured in blood samples collected from 135 patients treated at the University of Rochester Medical Center for myocardial infarction or stable ischemic heart disease requiring cardiac catheterization. Using ambient measurements of ultrafine, accumulation mode, and fine particles (PM2.5), Delta-C, and black carbon (BC), we regressed serum fibrinogen levels against pollutant concentrations over the previous 1–96 h, using interaction terms to estimate these associations separately for those with HIGH (> 5.12%) and LOWMED serum levels of ω-3 fatty acid (≤ 5.12%). Each 5.6 μg/m3 increase in PM2.5 concentration in the previous hour was associated with a 3.1% increase in fibrinogen (95% CI = 1.5%, 4.7%) in those subjects with LOWMED total ω-3 fatty acid levels, but only a 0.9% increase (95% CI = − 1.5%, 3.2%) in patients with HIGH total ω-3 fatty acid levels. This same pattern was observed with fish oil-derived docosahexaenoic and eicosapentaenoic acids but not alpha-linolenic (from plant oil or seeds). A similar finding was observed with BC in the prior 24 h, but not other PM. Thus, increased blood levels of fish-based ω-3 fatty acids attenuated increases in fibrinogen associated with short-term increases in ambient PM.
Highlights
Particulate air pollution (PM) has repeatedly been associated with an increased risk of acute cardiovascular events like myocardial infarction (Brook et al 2010)
Previous studies have examined whether intake of omega 3 (ω-3) fatty acids can reduce the risk of acute cardiovascular events and overall risk of cardiovascular disease (Harris et al 2008). ω-3 fatty acids include eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which are obtained from marine sources such as fish, and alpha-linolenic acid (ALA), a plant-derived fatty acid present in the oils of seeds, nuts, and beans (Harris et al 2008)
After adjusting for covariates, for each 0.29 μg/m3 increase in black carbon concentration lagged 24 h was associated with a 2.6% increase in fibrinogen levels in the LOW total ω-3 tertile and a 2.8% increase in the MEDIUM ω-3 tertile
Summary
Particulate air pollution (PM) has repeatedly been associated with an increased risk of acute cardiovascular events like myocardial infarction (Brook et al 2010). Other studies have reported associations between short-term increases in ambient air pollutants and adverse changes in plasma biomarkers of inflammation and coagulation (Rich et al 2012a, b; Ruckerl et al 2007), which are potential mediators of any pollutant effect on these acute cardiovascular events. Previous studies have examined whether intake of omega 3 (ω-3) fatty acids can reduce the risk of acute cardiovascular events and overall risk of cardiovascular disease (Harris et al 2008). Adequate DHA, EPA, and ALA blood concentrations have all been shown to be protective for cardiovascular disease (Chaddha and Eagle 2015; Mozaffarian and Wu 2011) including acute coronary syndrome (ACS) events (de Oliveira Otto et al 2013). While the cardioprotective effects of ω-3 fatty acids remain an active area of research, the American Heart Association currently states that supplementation with DHA and EPA is reasonable for patients with recent MI or heart failure with reduced ejection fraction (Siscovick et al 2017)
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