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Published on: February 21, 2011
Activation of the coagulant pathway in cigarette smokers
G J Miller1, K A Bauer, J A Cooper
1Medical Research Council Epidemiology and Medical Care Unit, London, England.
Insights
Chronic cigarette smoking significantly impacts blood coagulation, increasing levels of key clotting factors like Factor VII and fibrinogen. These changes in smokers and ex-smokers suggest a higher risk of arterial thrombosis.
Area of Science:
- Cardiovascular Medicine
- Hematology
- Public Health
Background:
- Chronic cigarette smoking is a major risk factor for cardiovascular disease.
- The coagulation system plays a critical role in thrombosis, a key mechanism in cardiovascular events.
Purpose of the Study:
- To investigate the impact of chronic cigarette smoking on various markers of the coagulation system.
- To assess differences in coagulation factors between current smokers, ex-smokers, and non-smokers.
Main Methods:
- Analysis of coagulation markers including Factor VII activity (VIIc), Factor VII antigen (VIIag), prothrombin fragment 1+2 (F1.2), fibrinopeptide A (FPA), and fibrinogen.
- Measurement of activated Factor VII (VIIa), Factor IX activation peptide (IX pep), and Factor X activation peptide (X pep) in a sub-sample.
- Statistical adjustment for conventional cardiovascular risk factors.
Main Results:
- Significant differences in coagulation indices (except FPA) were observed between non-smokers, ex-smokers, and current smokers.
- Factor VII activity (VIIc) was slightly elevated in ex-smokers and current smokers compared to non-smokers.
- Levels of Factor IX activation peptide (IX pep), Factor X activation peptide (X pep), prothrombin fragment 1+2 (F1.2), and fibrinogen were highest in current smokers, intermediate in ex-smokers, and lowest in non-smokers.
Conclusions:
- Chronic smoking alters the coagulation system, leading to increased levels of pro-thrombotic factors.
- The observed changes in coagulation markers in smokers and ex-smokers support the link between smoking and an increased risk of arterial thrombosis.
Abstract:
The effects of chronic cigarette smoking on the coagulation system were examined in 2964 men aged 50 to 61 years and clinically free of cardiovascular disease. Factor VII activity (VIIc), factor VII antigen (VIIag), prothrombin fragment 1+2 (F1.2), fibrinopeptide A (FPA) and fibrinogen were measured in all participants, and activated factor VII (VIIa), factor IX activation peptide (IX pep) and factor X activation peptide (X pep) in a large sub-sample. The levels of all indices except FPA differed significantly between non-smokers, ex-smokers and current smokers. After adjustment for other conventional cardiovascular risk factors, mean VIIc was raised slightly by 3% in ex-smokers and current smokers as compared with non-smokers, owing to increases in VIIa and VIIag. Plasma IX pep, X pep, F1.2 and fibrinogen concentration were highest in current smokers, intermediate in ex-smokers and lowest in non-smokers. These findings accord with the increased risk of arterial thrombosis in smokers.
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