A modern day perspective on smoking in peripheral artery disease

Abstract

Peripheral artery disease (PAD) is associated with increased risk of cardiovascular morbidity and mortality, poor functional status, and lower quality of life. Cigarette smoking is a major preventable risk factor for PAD and is strongly associated with a higher risk of disease progression, worse post-procedural outcomes, and increased healthcare utilization. The arterial narrowing due to atherosclerotic lesions in PAD leads to decreased perfusion to the limbs and can ultimately cause arterial obstruction and limb ischemia. Endothelial cell dysfunction, oxidative stress, inflammation, and arterial stiffness are among the key events during the development of atherogenesis. In this review, we discuss the benefits of smoking cessation among patients with PAD and the use of smoking cessation methods including pharmacological treatment. Given that smoking cessation interventions remain underutilized, we highlight the importance of incorporating smoking cessation treatments as part of the medical management of patients with PAD. Regulatory approaches to reduce the uptake of tobacco product use and support smoking cessation have the potential to reduce the burden of PAD.

Distinct genomic signatures and modifiable risk factors underly the comorbidity between major depressive disorder and cardiovascular disease

“…Analyzing risk factors explaining the effect of genetic liability to MDD on CVDs, we observed that only the association between genetic liability to MDD and coronary artery disease remained statistically significant after adjusting for psychosocial/lifestyle or metabolic covariates in a multivariable MR analysis. In addition, we found that smoking status attenuates the association between genetic liability to MDD and peripheral artery disease, for which smoking is a particularly strong risk factor 55 . Interestingly, we find that loneliness is an equally important factor explaining the relationship between MDD and peripheral artery disease, as well as heart failure, which is in line with the results from the adjusted genome-wide genetic correlation analysis discussed above.…”

Distinct biological signature and modifiable risk factors underlie the comorbidity between major depressive disorder and cardiovascular disease

“…On multivariable MR analysis, we observed that only the association between genetic liability to MDD and coronary artery disease remained statistically significant after adjusting for the psychosocial or lifestyle or metabolic covariates. We found that adjusting for smoking status attenuates the association between genetic liability to MDD and peripheral artery disease, for which smoking is a strong risk factor 67 . Interestingly, we find that loneliness is an equally important factor explaining the relationship between MDD and peripheral artery disease.…”

Lower limb arterial calcification and its clinical relevance with peripheral arterial disease

“…Studies on IAC, report positive associations with smoking and dyslipidemia ( 35 , 50 ). Nicotine found in tobacco promotes vascular calcification, and its mechanisms involve the hyperactivation of inflammatory responses, oxidative stress, autophagy, increased cell apoptosis, extracellular matrix degradation, and disruption of endothelial function ( 51 – 53 ). LDL causes the formation of atherosclerosis through various mechanisms, including the upregulation of inflammatory cytokines and adhesion molecules on vascular endothelial cells, increased transport of oxPLs, inhibition of nitric oxide synthesis, resulting in vascular remodeling, and promotion of smooth muscle cell proliferation and foam cell formation ( 54 ).…”