Short-term effects of the smoke-free legislation on haemostasis and systemic inflammation due to second hand smoke exposure

Guillaume Cayla; Pierre Sie; Johanne Silvain; Delphine Brugier; Jean-Pierre Cambou; Daniel Thomas; Ana Pena; Stephen A. O’Connor; Alessandra Bura; Jean-Bernard Ruidavets; Gilles Montalescot; Jean-Philippe Collet

doi:10.1160/TH11-02-0062

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2011; 105(06): 1024-1031
DOI: 10.1160/TH11-02-0062

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Short-term effects of the smoke-free legislation on haemostasis and systemic inflammation due to second hand smoke exposure

The AERER^[*] study

Guillaume Cayla

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Pierre Sie

²Toulouse Laboratory of Haematology, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC) INSERM 1048, CHU de Toulouse and Université Paul Sabatier, Toulouse, France

,

Johanne Silvain

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Delphine Brugier

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Jean-Pierre Cambou

³University of Toulouse, Rangueil University Hospital, Dept. of Vascular Medicine, Toulouse, France

,

Daniel Thomas

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Ana Pena

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Stephen A. O’Connor

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Alessandra Bura

³University of Toulouse, Rangueil University Hospital, Dept. of Vascular Medicine, Toulouse, France

,

Jean-Bernard Ruidavets

⁴Department of Epidemiology, Health Economics and Public Health, UMR 558 INSERM, Université de Toulouse, CHU de Toulouse, Toulouse, France

,

Gilles Montalescot

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

,

Jean-Philippe Collet

¹Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France

› Author Affiliations

Abstract

Summary

It was the objective of this study to assess the effect of the implementation of the smoke-free legislation on haemostasis and systemic inflammation in second-hand smoking (SHS)-exposed healthy volunteers. Fibrin-rich clot properties, platelet reactivity and inflammatory biomarkers were measured before and four months following the implementation of the smoke-free legislation in gender and age-matched healthy volunteers exposed (n=23, exposed) and unexposed (n=23, controls) to occupational SHS. The primary objective was to compare fibrin-rich clot stiffness before and after implementation of the smoke-free legislation. There was 40% reduction in fibrin-rich clot stiffness following the implementation of the smoke-free legislation in SHS-exposed volunteers (17 ± 7 vs. 10.6 ± 7 dynes/cm², before and after, respectively, p=0.001). These dramatic changes were associated with a 20% reduction in fibrin fiber density (p<0.01) and a 20% reduction inclot lysis time (p=0.05). No change in fibrin properties was observed in the control group of SHS-unexposed volunteers related to the implementation of the smoke-free legislation. Of interest, neither platelet reactivity nor systemic inflammatory biomarkers were changed in either group. The smoke-free legislation is associated with significant changes in fibrin-rich clot properties toward a less thrombogenic conformation with a better fibrinolysis response while neither platelet reactivity nor systemic inflammatory biomarkers are modified. These improvements may explain the observed reduction in acute coronary syndrome following the implementation of the smoke-free legislation.

Keywords

Second hand smoke - smoke-free legislation - fibrin-clot - platelet reactivity - inflammatory biomarkers

Full Text

References

References
1 Jonas MA. et al. Statement on smoking and cardiovascular disease for health care professionals. American Heart Association. Circulation 1992; 86: 1664-1669.
2 Ambrose JA, Barua RS. The pathophysiology of cigarette smoking and cardiovascular disease: an update. J Am Coll Cardiol 2004; 43: 1731-1737.
3 Barua RS. et al. Reactive oxygen species are involved in smoking-induced dysfunction of nitric oxide biosynthesis and upregulation of endothelial nitric oxide synthase: an in vitro demonstration in human coronary artery endothelial cells. Circulation 2003; 107: 2342-2347.
4 Barnoya J, Glantz SA. Cardiovascular effects of secondhand smoke: nearly as large as smoking. Circulation 2005; 111: 2684-2698.
5 Teo KK. et al. Tobacco use and risk of myocardial infarction in 52 countries in the INTERHEART study: a case-control study. Lancet 2006; 368: 647-658.
6 Oberg M. et al. Worldwide burden of disease from exposure to second-hand smoke: a retrospective analysis of data from 192 countries. Lancet 2011; 377: 139-146.
7 Lightwood JM, Glantz SA. Declines in acute myocardial infarction after smoke-free laws and individual risk attributable to secondhand smoke. Circulation 2009; 120: 1373-1379.
8 Mackay DF. et al. Meta-analysis of the effect of comprehensive smoke-free legislation on acute coronary events. Heart 2010; 96: 1525-1530.
9 Collet JP. et al. Altered fibrin architecture is associated with hypofibrinolysis and premature coronary atherothrombosis. Arterioscler Thromb Vasc Biol 2006; 26: 2567-2573.
10 Barua RS. et al. Effects of cigarette smoke exposure on clot dynamics and fibrin structure: an ex vivo investigation. Arterioscler Thromb Vasc Biol 2010; 30: 75-79.
11 Rop PP. et al. Determination of nicotine and its main metabolites in urine by high-performance liquid chromatography. J Chromatogr 1993; 612: 302-309.
12 Verbeke M. Linear Mixed Models for Longitudinal Data. 2nd ed New York: Springer-Verlag; 2001
13 Sims M. et al. Short term impact of smoke-free legislation in England: retrospective analysis of hospital admissions for myocardial infarction. Br Med J 2010; 340: c2161.
14 Scott EM. et al. Genetic and Environmental Determinants of Fibrin Structure and Function Relevance to Clinical Disease. Atheroscler Thromb Vasc Biol 2004; 24: 1558-1566.
15 Collet JP. et al. Influence of fibrin network conformation and fibrin fiber diameter on fibrinolysis speed: dynamic and structural approaches by confocal microscopy. Arterioscler Thromb Vasc Biol 2000; 20: 1354-1361.
16 Undas A. et al. Fibrin clot properties are altered in patients with chronic obstructive pulmonary disease. Beneficial effects of simvastatin treatment. Thromb Haemost 2009; 102: 1176-1182.
17 Mills JD. et al. Altered fibrin clot structure in the healthy relatives of patients with premature coronary artery disease. Circulation 2002; 106: 1938-1942.
18 Morita H. et al. Only two-week smoking cessation improves platelet aggregability and intraplatelet redox imbalance of long-term smokers. J Am Coll Cardiol 2005; 45: 589-594.
19 Takajo Y. et al. Augmented oxidative stress of platelets in chronic smokers. Mechanisms of impaired platelet-derived nitric oxide bioactivity and augmented platelet aggregability. J Am Coll Cardiol 2001; 38: 1320-1327.
20 Fusegawa Y, Handa S. Platelet aggregation induced by ADP or epinephrine is enhanced in habitual smokers. Thromb Res 2000; 97: 287-295.
21 Rubenstein D. et al. Differences between mainstream and sidestream cigarette smoke extracts and nicotine in the activation of platelets under static and flow conditions. Circulation 2004; 109: 78-83.
22 Undas A. et al. Statins, fenofibrate, and quinapril increase clot permeability and enhance fibrinolysis in patients with coronary artery disease. J Thromb Haemost 2006; 4: 1029-1036.
23 Blache D. Involvement of hydrogen and lipid peroxides in acute tobacco smoking-induced platelet hyperactivity. Am J Physiol 1995; 268: H679-685.
24 Fusegawa Y. et al. Platelet spontaneous aggregation in platelet-rich plasma is increased in habitual smokers. Thromb Res 1999; 93: 271-278.
25 Roitman EV. et al. Oxidatively modified fibrinogen modulates blood rheological parameters. Bull Exp Biol Med 2004; 138: 467-469.
26 Tetik S. et al. Oxidative modification of fibrinogen affects its binding activity to glycoprotein (GP) IIb/IIIa. Clin Appl Thromb Hemost 2010; 16: 51-59.
27 Venn A, Britton J. Exposure to secondhand smoke and biomarkers of cardiovascular disease risk in never-smoking adults. Circulation 2007; 115: 990-995.
28 Jefferis BJ. et al. Secondhand smoke (SHS) exposure is associated with circulating markers of inflammation and endothelial function in adult men and women. Atherosclerosis 2010; 208: 550-556.
29 Yanbaeva DG. et al. Systemic effects of smoking. Chest 2007; 131: 1557-1566.
30 Rudez G. et al. Biological variation in inflammatory and hemostatic markers. J Thromb Haemost 2009; 7: 1247-1255.
31 Bura A. et al. Impact of smoking prohibition in bars, restaurants and discotheques on employees endothelial function: the DILATER study. European Heart J. 2009 Suppl.: Abstract 584.