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Smoking, haemostatic factors and lipid peroxides in a population case control study of peripheral arterial disease

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      Abstract

      The aim of this study was to determine differences between cases of peripheral arterial disease and healthy controls in levels of haemostatic factors and lipid peroxides and the influence of cigarette smoking. The study groups were selected from the Edinburgh Artery Study which is a random sample survey of men and women aged 55–74 years. Mean levels of plasma fibrinogen, von Willebrand factor, β-thromboglobulin, plasminogen activator inhibitor (type I), cross-linked fibrin degradation products and lipid peroxides were markedly elevated in 121 study cases compared with 126 age- and sex-matched controls. For example, cross-linked fibrin degradation products had a geometric mean of 106.8 ng/ml (95% confidence interval (CI) 95.3, 119.8) in study cases and 74.7 ng/ml (95% CI 67.0, 83.4) in controls (P < 0.001). Inclusion of smoking in logistic regressions of each factor on peripheral arterial disease significantly reduced the odds of disease for von Willebrand factor and for cross-linked fibrin degradation products, but had little effect on the increased odds associated with fibrinogen, β-thromboglobulin, plasminogen activator inhibitor and lipid peroxides. We conclude that, in men and women in Edinburgh, peripheral atherosclerosis is associated with lipid peroxidation, endothelial disturbance, platelet activation, elevated fibrinogen, fibrin formation and increased inhibition of fibrinolysis. The most important effects of cigarette smoking in promoting atherosclerosis may be endothelial disturbance and fibrin formation.

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      References

        • Lowe G.D.O.
        • Rumley A.
        The biochemistry of critical limb ischaemia.
        Crit. Ischaemia. 1991; 1: 11
        • Fowkes F.G.R.
        • Housley E.
        • Cawood E.H.H.
        • Macintyre C.A.A.
        • Ruckley C.V.
        • Prescott R.J.
        Edinburgh Artery Study: prevalence of asymptomatic and symptomatic peripheral arterial disease in the general population.
        Int. J. Epidemiol. 1991; 20: 384
        • Fowkes F.G.R.
        • Housley E.
        • Riemersma R.A.
        • et al.
        Smoking, lipids, glucose intolerance, and blood pressure as risk factors for peripheral atherosclerosis compared to ischaemic heart disease in the Edinburgh Artery Study.
        Am. J. Epidemiol. 1992; 135: 331
        • Lowe G.D.O.
        • Fowkes F.G.R.
        • Dawes J.
        • et al.
        Blood viscosity, fibrinogen and activation of coagulation and leucocytes in peripheral arterial disease and the normal population in the Edinburgh Artery Study.
        Circulation. 1993; 87: 1915
        • Baker I.A.
        • Eastham R.
        • Elwood P.C.
        Haemostatic factors associated with ischaemic heart disease in men aged 45 to 64 years. The Speedwell Study.
        Br. Heart J. 1982; 47: 490
        • Christe M.
        • Delley A.
        • Marbet G.A.
        • Cilard L.
        • Duckert F.
        Fibrinogen, factor VIII related antigen, antithrombin III and 2 antiplasmin in peripheral arterial disease.
        Thromb. Haemostas. 1984; 52: 250
        • Cella G.
        • Zahavi J.
        • de Haas H.A.
        • Kakkar V.V.
        β-Thromboglobulin, platelet production time and platelet function in vascular disease.
        Br. J. Haematol. 1979; 43: 127
        • Browse N.L.
        • Gray L.
        • Jarrett P.E.M.
        Blood and vein-wall fibrinolytic activity in health and vascular disease.
        Br. Med. J. 1977; i: 478
        • Kruithof E.K.O.
        Plasminogen activator inhibitor type 1: biochemical, biological and clinical aspects.
        Fibrinolysis. 1988; 2: 59
        • Al-Zahrani H.
        • Lowe G.D.O.
        • Douglas J.T.
        • et al.
        Increased fibrin turnover in peripheral arterial disease: comparison with a population study.
        Clin. Hemorheol. 1992; 12: 867
        • Stringer M.D.
        • Grörog P.D.
        • Freeman A.
        • Kakkar V.V.
        Lipid peroxides and atherosclerosis.
        Br. Med. J. 1989; 298: 281
        • Iverson S.A.
        • Cawood T.
        • Dormandy T.L.
        A method for the measurement of a diene conjugated derivative of linoleic acid, 18:2 (9,11), in serum phospholipid and possible origins.
        Ann. Clin. Biochem. 1985; 22: 137
        • Rose G.A.
        The diagnosis of ischaemic heart pain and intermittent claudication in field surveys.
        Bull. WHO. 1962; 27: 645
        • Prineas R.J.
        • Crow R.S.
        • Blackburn H.
        The Minnesota Code Manual of Electrocardiographic Findings: Standards and Procedures for Measurement and Classification.
        Wright-PSG, Boston1982
        • Fowkes F.G.R.
        The measurement of atherosclerotic peripheral arterial disease in epidemiological surveys.
        Int. J. Epidemiol. 1988; 17: 248
        • Schlesselman J.J.
        Case Control Studies. Design, Conduct, Analysis.
        Oxford University Press, New York1982
        • Dixon W.J.
        • Brown M.B.
        BMDP Statistical Software.
        University of California Press, Berkeley, CA1981
        • Thompson F.
        • Smith M.T.
        Measurement of the diene conjugate form of linoleic acid in plasma by HPLC: a questionable non-invasive assay of free radical activity.
        Chem.-Biol. Interact. 1985; 55: 357
        • Allen R.A.
        • Kluft C.
        • Brommer E.J.P.
        The acute effect of smoking on fibrinolysis: increase in the level of circulating extrinsic (tissue-type) plasminogen activator.
        J. Clin. Invest. 1984; 14: 354
        • Belch J.J.F.
        • McArdle B.M.
        • Burns P.
        • Lowe G.D.O.
        • Forbes C.D.
        The effects of acute smoking on platelet behaviour, fibrinolysis and haemorheology in habitual smokers.
        Thromb. Haemostas. 1984; 51: 6
        • Pittilo R.M.
        • Mackie I.J.
        • Rowles P.M.
        • Machim S.J.
        • Wooly N.
        Effects of cigarette-smoking on the ultrastructure of rat thoracic aorta and its ability to produce prostacyclin.
        Thromb. Haemostas. 1982; 48: 173
        • Ross R.
        The pathogenesis of atherosclerosis — an update.
        N. Engl. J. Med. 1986; 314: 488
        • Dormandy J.A.
        • Hoare E.
        • Colley J.
        • Arrowsmith D.E.
        • Dormandy T.L.
        Clinical haemodynamic, rheological and biochemical findings in 126 patients with intermittent claudication.
        Br. Med. J. 1973; iv: 576
        • Hughson W.G.
        • Mann J.I.
        • Garrod A.
        Intermittent claudication: prevalence and risk factors.
        Br. Med. J. 1978; i: 1379
        • Connor J.M.
        • Fowkes F.G.R.
        • Wood J.
        • Smith F.B.
        • Donnan P.T.
        • Lowe G.D.O.
        Genetic variation at fibrinogen loci and plasma fibrinogen levels.
        J. Med. Genet. 1992; 29: 480
        • Fowkes F.G.R.
        • Connor J.M.
        • Smith F.B.
        • Wood J.
        • Donnan P.T.
        • Lowe G.D.O.
        Fibrinogen genotype and risk of peripheral atherosclerosis.
        Lancet. 1992; 339: 693
        • Fowkes F.G.R.
        • Lowe G.D.O.
        • Housley E.
        • et al.
        Cross linked fibrin degradation products, progression of peripheral arterial disease and risk of coronary heart disease.
        Lancet. 1993; 342: 84