NCT00809653

Brief Summary

Air pollution is a major cause of cardiorespiratory morbidity and mortality. The exact components of air pollution that underlie the cardiovascular effects are not yet known, but combustion-derived particulate matter is suspected to be the major cause. Epidemiological studies have shown that exposure to air pollution causes exacerbation of existing cardiorespiratory conditions leading to increased hospital admissions and death. The investigators have recently conducted a series of controlled exposure studies to urban particulate matter and diesel exhaust in healthy volunteers and patients with coronary heart disease. The investigators found that controlled exposure to dilute diesel exhaust in patients with prior myocardial infarction induced asymptomatic myocardial ischaemia with an increase in electrocardiographic measures of myocardial ischaemia. Whilst important, further questions remain: (i) does air pollution exposure exacerbate ischaemia and reduce exercise tolerance in patients with symptomatic angina pectoris, (ii) do "real world" exposures as encountered in the urban environment of major cities have similar effects, and (iii) can a simple face mask intervention to reduce exposure to particulate air pollution improve health outcomes in patients with coronary heart disease?

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
100

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2009

Shorter than P25 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 15, 2008

Completed
2 days until next milestone

First Posted

Study publicly available on registry

December 17, 2008

Completed
15 days until next milestone

Study Start

First participant enrolled

January 1, 2009

Completed
4 months until next milestone

Primary Completion

Last participant's last visit for primary outcome

May 1, 2009

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

May 1, 2009

Completed
Last Updated

March 31, 2010

Status Verified

May 1, 2009

Enrollment Period

4 months

First QC Date

December 15, 2008

Last Update Submit

March 30, 2010

Conditions

Keywords

Air pollutionFace maskMyocardial ischaemiaHeart rate variabilityAngina pectorisCoronary heart disease

Outcome Measures

Primary Outcomes (1)

  • Myocardial ischaemic burden determined using continuous electrographic monitoring

    During 2 hour walk and subsequent 24 hour period

Secondary Outcomes (7)

  • Symptoms of angina pectoris assessed by patient diary and GTN use

    During 2 hour walk and subsequent 24 hour period

  • Biochemical markers of myocardial ischaemia

    After 2 hour city centre walk

  • Systemic inflammatory markers

    After 2 hour city centre walk

  • Blood pressure

    During 2 hour walk and for subsequent 24 hours

  • Heart rate and heart rate variability

    During 2 hour walk and subsequent 24 hour period

  • +2 more secondary outcomes

Study Arms (2)

Visit 1

EXPERIMENTAL

2 hour walk in city centre location in Beijing China

Device: No Face Mask

Visit 2

EXPERIMENTAL

2 hour walk in city centre location in Beijing China

Device: Face Mask

Interventions

Subjects will not wear a face mask to reduce their personal air pollution exposure

Visit 1
Face MaskDEVICE

Subjects will be asked to wear a simple face mask to reduce personal exposure to particulate air pollution. Subjects will be asked to wear the mask for 24 hours prior to the study day and the 24 hours of the study day. They will be instructed to wear the mask at all times when outdoors and as much as possible when indoors.

Also known as: 3M Dust Respirator 8812
Visit 2

Eligibility Criteria

Sexall
Healthy VolunteersNo
Age GroupsChild (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

  • Stable coronary heart disease
  • Symptoms of angina pectoris
  • Evidence of coronary heart disease by angiography or by exercise stress testing

You may not qualify if:

  • Current smokers
  • History of arrhythmia
  • Severe 3 vessel coronary heart disease or left main stem stenosis that has not been revascularised
  • Resting conduction abnormality
  • Digoxin therapy
  • Uncontrolled hypertension
  • Renal failure
  • Hepatic failure
  • Acute coronary syndrome or unstable symptoms within 3 months
  • Significant occupation exposure to air pollution

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Medical Union College

Beijing, China

Location

Related Publications (3)

  • Mills NL, Tornqvist H, Gonzalez MC, Vink E, Robinson SD, Soderberg S, Boon NA, Donaldson K, Sandstrom T, Blomberg A, Newby DE. Ischemic and thrombotic effects of dilute diesel-exhaust inhalation in men with coronary heart disease. N Engl J Med. 2007 Sep 13;357(11):1075-82. doi: 10.1056/NEJMoa066314.

    PMID: 17855668BACKGROUND
  • Langrish JP, Watts SJ, Hunter AJ, Shah AS, Bosson JA, Unosson J, Barath S, Lundback M, Cassee FR, Donaldson K, Sandstrom T, Blomberg A, Newby DE, Mills NL. Controlled exposures to air pollutants and risk of cardiac arrhythmia. Environ Health Perspect. 2014 Jul;122(7):747-53. doi: 10.1289/ehp.1307337. Epub 2014 Mar 25.

  • Langrish JP, Li X, Wang S, Lee MM, Barnes GD, Miller MR, Cassee FR, Boon NA, Donaldson K, Li J, Li L, Mills NL, Newby DE, Jiang L. Reducing personal exposure to particulate air pollution improves cardiovascular health in patients with coronary heart disease. Environ Health Perspect. 2012 Mar;120(3):367-72. doi: 10.1289/ehp.1103898.

MeSH Terms

Conditions

Angina PectorisCoronary DiseaseCoronary Artery Disease

Interventions

Masks

Condition Hierarchy (Ancestors)

Myocardial IschemiaHeart DiseasesCardiovascular DiseasesVascular DiseasesChest PainPainNeurologic ManifestationsSigns and SymptomsPathological Conditions, Signs and SymptomsArteriosclerosisArterial Occlusive Diseases

Intervention Hierarchy (Ancestors)

Surgical AttireEquipment and Supplies, HospitalEquipment and SuppliesProtective DevicesPersonal Protective EquipmentSurgical EquipmentManufactured MaterialsTechnology, Industry, and Agriculture

Study Officials

  • Lixin Jiang, MD

    Chinese Academy of Medical Sciences and Peking Medical Union College

    PRINCIPAL INVESTIGATOR
  • David E Newby, PhD FRCP

    University of Edinburgh

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
BASIC SCIENCE
Intervention Model
CROSSOVER
Sponsor Type
OTHER

Study Record Dates

First Submitted

December 15, 2008

First Posted

December 17, 2008

Study Start

January 1, 2009

Primary Completion

May 1, 2009

Study Completion

May 1, 2009

Last Updated

March 31, 2010

Record last verified: 2009-05

Locations