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European Heart Journal Advance Access originally published online on April 7, 2005
European Heart Journal 2005 26(17):1765-1773; doi:10.1093/eurheartj/ehi183
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Associations between cigarette smoking, pipe/cigar smoking, and smoking cessation, and haemostatic and inflammatory markers for cardiovascular disease

S. Goya Wannamethee1,*, Gordon D.O. Lowe2, A. Gerald Shaper1, Ann Rumley2, Lucy Lennon1 and Peter H. Whincup3

1Department of Primary Care and Population Sciences, Royal Free and University College Medical School, Rowland Hill St, London NW3 2PF, UK
2University Department of Medicine, Royal Infirmary, Glasgow, UK
3Department of Public Health Sciences, St George's Medical School Hospital, London, UK

Received 26 July 2004; revised 20 January 2005; accepted 27 January 2005; online publish-ahead-of-print 7 April 2005.

* Corresponding author. Tel: +20 7830 2239; fax: +20 7794 1224. E-mail address: goya{at}pcps.ucl.ac.uk

Aims To examine the associations between cigarette smoking, pipe/cigar smoking, and years since quitting smoking, and inflammatory and haemostatic markers.

Methods and results A study in 2920 men aged 60–79 with no history of myocardial infarction, angina, stroke, or diabetes, and who were not on warfarin, from general practices in 24 British towns. After adjustment for other major cardiovascular risk factors, compared with never smokers, current cigarette smokers showed significantly higher levels of C-reactive protein (2.53 vs. 1.35 mg/L), white cell count (7.92 vs. 6.42x109/L), and fibrinogen (3.51 vs. 3.13 g/L). They also showed higher levels of haematocrit, blood and plasma viscosity, tissue plasminogen activator antigen, and fibrin D-dimer, and lower levels of albumin. Primary pipe/cigar smokers showed levels similar to never smokers. Ex-cigarette smokers and secondary pipe/cigar smokers showed intermediate levels although secondary pipe/cigar smokers showed higher odds of having elevated white cell count and fibrinogen than ex-cigarette smokers. Most inflammatory and haemostatic levels improved within 5 years of smoking cessation but took over 20 years to revert to levels of never smokers.

Conclusion These findings suggest that activation of inflammation and haemostasis may be potential mechanisms by which cigarette and pipe/cigar smoking increase cardiovascular risk.

Key Words: Cigarette smoking • Pipe cigar • Inflammation • Haemostasis • Smoking cessation


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