The relationship between smoking intensity and subclinical cardiovascular injury: The Multi-Ethnic Study of Atherosclerosis (MESA)

Abstract

Background and aims Modern tobacco regulatory science requires an understanding of which biomarkers of cardiovascular injury are most sensitive to cigarette smoking exposure. Methods We studied self-reported current smokers from the Multi-Ethnic Study of Atherosclerosis. Smoking intensity was defined by number of cigarettes/day and urinary cotinine levels. Subclinical cardiovascular injury was assessed using markers of inflammation [high-sensitivity C-reactive protein (hsCRP), interleukin 6 & 2 (IL-2 & IL-6), tumor necrosis factor alpha (TNF-α)], thrombosis (fibrinogen, D-dimer, homocysteine), myocardial injury (troponin T; TnT), endothelial damage (albumin: creatinine ratio), and vascular function [aortic & carotid distensibility, flow-mediated dilation (FMD)]. Biomarkers were modeled as absolute and percent change using multivariable-adjusted linear regression models adjusted for cardiovascular risk factors and smoking duration. Results Among 843 current smokers, mean age was 58 (9) years, 53% were men, 39% were African American, mean number of cigarettes per day was 13 (10), and median smoking duration was 39 (15) years. Cigarette count was significantly associated with higher hsCRP, IL-6 and fibrinogen (β coefficients: 0.013, 0.011, 0.60 respectively), while In-transformed cotinine was associated with the same biomarkers (β coefficients: 0.12, 0.04, 5.3 respectively) and inversely associated with aortic distensibility (β coefficient: −0.13). There was a limited association between smoking intensity and homocysteine, D-dimer, and albumin:creatinine ratio in partially adjusted models only, while there was no association with IL-2, TNF-α, carotid distensibility, FMD, or TnT in any model. In percent change analyses, relationships were strongest with hsCRP. Conclusions Smoking intensity was associated with early biomarkers of CVD, particularly, markers of systemic inflammation. Of these, hsCRP may be the most sensitive.

Association Between Smoking and Serum GlycA and High‐Sensitivity C‐Reactive Protein Levels: The Multi‐Ethnic Study of Atherosclerosis (MESA) and Brazilian Longitudinal Study of Adult Health (ELSA‐Brasil)

“…In this cross‐sectional study, we investigated whether smoking is associated with systemic inflammation as measured by GlycA levels. We also sought to compare the strength of association of smoking and GlycA versus the association of smoking and hsCRP, which is shown to be a sensitive candidate inflammatory biomarker of smoking exposure …”

“…We also sought to compare the strength of association of smoking and GlycA versus the association of smoking and hsCRP, which is shown to be a sensitive candidate inflammatory biomarker of smoking exposure. 13 The MESA (Multi-Ethnic Study of Atherosclerosis) and the ELSA-Brasil (Brazilian Longitudinal Study of Adult Health) have included modern cohorts, and share very similar study design and methodology for measuring serum biomarkers. For example, GlycA was measured for both MESA and ELSA-Brasil in the same site by the same staff.…”

Effects of cigarette smoking on coagulation screening tests and platelet counts in a Sudanese male adults population

“… 4 Some research demonstrated higher risk of thrombosis related to cardiomyocyte mitochondria oxidative damage and increased in smooth muscle cell proliferation and platelet aggregation. 5 - 7 Cigarette smoking exposure effects on hemostasis have been documented in decreased expression tissue factor pathway inhibitor and increased smokers plasma fibrinogen levels compared to non-smokers. 8 , 9 Few studies examined the effects of acute CSE on clotting, but circulating tissue factor activity increased levels have been demonstrated after short-term of cigarette smoking.…”

Associação entre fatores de risco cardiovasculares e a presença de doença arterial coronariana

“…O tabagismo apresenta um alto risco no desenvolvimento de DAC como mostram os estudos de Katsiki et al [24] e Jensen-Urstad et al [25]. Um estudo realizado por Rifai et al [26] revelou que a chance de um fumante desenvolver aterosclerose em comparação com não fumante é 70% maior. Como o desenho do presente estudo é transversal, a associação entre tabagismo e DAC pode não ter sido significativa estatisticamente pelo fato de que os pacientes que já tiveram um episódio de IAM ou revascularização, deixaram de fumar após este evento, e relataram ser não tabagistas no momento da realização do exame.…”