Related Experiment Videos
Pathology of the coronary arteries in smokers and non-smokers
1Department of Cardiology B, Aarhus University Hospital (SKS), Denmark.
Insights
Cigarette smoking significantly increases cardiovascular disease risk, primarily through promoting blood clot formation (thrombogenesis), rather than directly accelerating atherosclerosis. This review highlights smoking
Area of Science:
- Cardiovascular Medicine
- Toxicology
- Pathophysiology
Background:
- Cigarette smoking is a major risk factor for cardiovascular diseases (CVDs) including ischemic heart disease and stroke.
- Atherosclerosis and thrombosis are the underlying pathological processes in these smoking-related CVDs.
- The precise mechanisms by which smoking contributes to CVD, specifically its atherogenic vs. thrombogenic effects, remain debated.
Purpose of the Study:
- To review and synthesize clinical and experimental evidence on the atherogenicity and thrombogenicity of cigarette smoking.
- To elucidate the relative contributions of smoking-induced atherosclerosis and thrombosis to cardiovascular disease development.
- To clarify the role of smoking in the pathogenesis of ischemic heart disease and acute coronary syndromes.
Main Methods:
- Comprehensive literature review of clinical studies and experimental research.
- Analysis of data examining the effects of cigarette smoking on atherosclerotic plaque development.
- Evaluation of evidence related to smoking's impact on blood coagulation and thrombotic events.
Main Results:
- Evidence supporting a significant atherogenetic effect of smoking is limited, with only a moderate impact on coronary artery atherosclerosis observed.
- Clinical and experimental data strongly indicate that smoking-induced thrombogenesis is a primary driver of increased ischemic heart disease.
- Smoking's role in acute coronary syndromes appears predominantly linked to its thrombotic effects.
Conclusions:
- The atherogenetic effect of cigarette smoking on cardiovascular disease is less pronounced than previously assumed.
- Thrombogenetic factors induced by smoking are the main contributors to the elevated risk of ischemic heart disease.
- Targeting smoking-related thrombogenicity may be crucial for preventing cardiovascular events in smokers.
Abstract:
Cigarette smoking is known to be a strong risk factor for several cardiovascular diseases such as ischaemic heart disease, stroke, intermittent claudication and aortic aneurysm. Atherosclerosis, often with superimposed thrombosis, has been shown to be the underlying disease process in all of these diseases. This fact has led to the assumption that smoking accelerates the atherosclerotic process and thereby promotes premature cardiovascular disease. However, increased occurrence of smoking-mediated thrombosis might also play a causative role. This review therefore considers clinical and experimental evidence regarding the atherogenicity and thrombogenicity of cigarette smoking in the development and occurrence of cardiovascular disease. On the basis of the currently available literature, it is concluded that evidence for the atherogenetic effect of smoking is scarce, and that the effect on the athrosclerotic process in the coronary arteries is only moderate if present at all. On the other hand, both clinical and experimental data strongly support the notion that thrombogenetic factors are responsible for the increased occurrence of ischaemic heart disease, and particularly acute coronary syndromes, among chronic smokers.