Chonnam Med J.  2012 Apr;48(1):47-51. 10.4068/cmj.2012.48.1.47.

Clinical Outcome of Veterans with Acute Coronary Syndrome Who Had Been Exposed to Agent Orange

Affiliations
  • 1Department of Internal Medicine, Gwangju Veterans Hospital, Gwangju, Korea. gpkwy@naver.com

Abstract

2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD), one of the components of Agent Orange, has been reported to be a deadly poison despite its presence at extremely small doses. TCDD is reported to cause various kinds of cancers and other harmful effects on humans. However, a correlation between exposure to TCDD and acute coronary syndrome (ACS) is not yet proven. Thus, we examined the correlation between exposure to TCDD and ACS through an analysis of coronary angiograms from veterans of the Vietnam War. Two hundred fifty-one consecutive men undergoing coronary angiograms owing to ACS between April 2004 and May 2009 at Gwangju Veterans Hospital were analyzed. Included subjects were between 50 and 70 years of age. The patients were divided into two groups: 121 patients who had been exposed to TCDD (Group I) and 130 patients who had not been exposed to TCDD (Group II). Clinical and coronary angiographic findings were evaluated. Baseline clinical characteristics, inflammatory markers, and echocardiographic parameters were not significantly different between the two groups. The incidence of hypertension (71.1% vs. 60.0%, p=0.039) and hyperlipidemia (27.3% vs. 16.9%, p=0.038) was higher in Group I than in Group II. Total occlusion, stent length, stent use, and coronary lesion characteristics were not significantly different between the two groups. The rate of major adverse cardiovascular events (MACE) had no relationship with exposure to TCDD. Exposure to TCDD might not affect severity or the rate of MACE in persons with ACS.

Keyword

Acute coronary syndrome; TCDD; Angiography

MeSH Terms

2,4,5-Trichlorophenoxyacetic Acid
2,4-Dichlorophenoxyacetic Acid
Acute Coronary Syndrome
Angiography
Citrus sinensis
Hospitals, Veterans
Humans
Hyperlipidemias
Hypertension
Incidence
Male
Stents
Tetrachlorodibenzodioxin
Veterans
Vietnam
2,4,5-Trichlorophenoxyacetic Acid
2,4-Dichlorophenoxyacetic Acid
Tetrachlorodibenzodioxin

Reference

1. Gaylor DW, Aylward LL. An evaluation of benchmark dose methodology for non-cancer continuous-data health effects in animals due to exposures to dioxin (TCDD). Regul Toxicol Pharmacol. 2004; 40:9–17. PMID: 15265602.
2. Abbott BD. Review of the interaction between TCDD and glucocorticoids in embryonic palate. Toxicology. 1995; 105:365–373. PMID: 8571373.
3. Tuomisto JT, Pohjanvirta R, Unkila M, Tuomisto J. TCDD-induced anorexia and wasting syndrome in rats: effects of diet-induced obesity and nutrition. Pharmacol Biochem Behav. 1999; 62:735–742. PMID: 10208380.
4. Mehta SR, Granger CB, Boden WE, Steg PG, Bassand JP, Faxon DP, et al. TIMACS Investigators. Early versus delayed invasive intervention in acute coronary syndromes. N Engl J Med. 2009; 360:2165–2175. PMID: 19458363.
5. Harrison RJ. Chemicals and gases. Prim Care. 2000; 27:917–982. PMID: 11072294.
6. Institute of Medicine (U.S.). Committee to Review the Health Effects in Vietnam Veterans of Exposure to herbicides. Veterans and Agent Orange : Health effects of herbicides used in Vietnam. 1994. Washington D.C.: National academy press;p. 433–452.
7. Pavuk M, Schecter AJ, Akhtar FZ, Michalek JE. Serum 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) levels and thyroid function in Air Force veterans of the Vietnam War. Ann Epidemiol. 2003; 13:335–343. PMID: 12821272.
8. Henriksen GL, Ketchum NS, Michalek JE, Swaby JA. Serum dioxin and diabetes mellitus in veterans of Operation Ranch Hand. Epidemiology. 1997; 8:252–258. PMID: 9115019.
9. Calvert GM, Sweeney MH, Deddens J, Wall DK. Evaluation of diabetes mellitus, serum glucose, and thyroid function among United States workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin. Occup Environ Med. 1999; 56:270–276. PMID: 10450245.
10. Remillard RB, Bunce NJ. Use of Haber's Rule to estimate the risk of diabetes from background exposures to dioxin-like compounds. Toxicol Lett. 2002; 131:161–166. PMID: 11992735.
11. Ray S, Swanson HI. Activation of the aryl hydrocarbon receptor by TCDD inhibits senescence: a tumor promoting event? Biochem Pharmacol. 2009; 77:681–688. PMID: 19100242.
12. Brewster DW, Matsumura F, Akera T. Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin on guinea pig heart muscle. Toxicol Appl Pharmacol. 1987; 89:408–417. PMID: 3603569.
13. Kelling CK, Menahan LA, Peterson RE. Effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin treatment on mechanical function of the rat heart. Toxicol Appl Pharmacol. 1987; 91:497–501. PMID: 3424379.
14. Hermansky SJ, Holcslaw TL, Murray WJ, Markin RS, Stohs SJ. Biochemical and functional effects of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) on the heart of female rats. Toxicol Appl Pharmacol. 1988; 95:175–184. PMID: 3420610.
15. Kanzawa N, Kondo M, Okushima T, Yamaguchi M, Temmei Y, Honda M, et al. Biochemical and molecular biological analysis of different responses to 2,3,7,8-tetrachlorodibenzo-p-dioxin in chick embryo heart and liver. Arch Biochem Biophys. 2004; 427:58–67. PMID: 15178488.
16. Kim JS, Lim HS, Cho SI, Cheong HK, Lim MK. Impact of Agent Orange exposure among Korean Vietnam veterans. Ind Health. 2003; 41:149–157. PMID: 12916744.
17. Kang HK, Dalager NA, Needham LL, Patterson DG Jr, Lees PS, Yates K, et al. Health status of Army Chemical Corps Vietnam veterans who sprayed defoliant in Vietnam. Am J Ind Med. 2006; 49:875–884. PMID: 17006952.
Full Text Links
  • CMJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr