Key result
Persistent smoking significantly increased the risk of atherothrombotic events (HR 3.20) and was associated with upregulated monocyte tissue factor activity and progression of carotid atherosclerosis in patients with metabolic syndrome.
Why the study?
Does persistent smoking increase the risk of atherothrombotic events, monocyte tissue factor activity, and carotid atherosclerosis in patients with metabolic syndrome?
Cohort (n=301)
No
Does persistent smoking increase the risk of atherothrombotic events, monocyte tissue factor activity, and carotid atherosclerosis in patients with metabolic syndrome?
Hazard Ratio: 3.2 (95% CI 1.02–10.12)
p-value: p=0.048
Persistent smoking in patients with metabolic syndrome is associated with upregulated monocyte tissue factor activity, progression of carotid atherosclerosis, and a significantly increased risk of atherothrombotic events.
Smoking may heighten atherothrombotic risk via MTFA in MetS; leaves open causal mechanisms and intervention targets.
BACKGROUND: Smoking increases the risk of atherothrombotic events. Tissue factor (TF) mainly expressed on monocytes plays an important role in thrombosis and atherosclerosis. Metabolic syndrome (MetS) is being increasingly recognized as a major atherothrombotic risk factor, but the effects of smoking on monocyte TF activity (MTFA), carotid atherosclerosis estimated on carotid intima-media thickness (CIMT), and long-term prognosis in MetS remain unclear. METHODS AND RESULTS: A total of 301 MetS patients lacking any known cardiovascular disease were prospectively investigated and classified into 4 groups according to smoking status at entry and at 12 months as follows: never smokers, past smokers, quitters, and persistent smokers. Peripheral blood mononuclear cells (PBMC) were isolated, and MTFA was measured using a coagulation assay. Linear trends for higher baseline MTFA and CIMT were observed among persistent smokers, quitters, and past smokers compared with never smokers. At 12 months, MTFA and CIMT decreased in never and past smokers and quitters but increased in persistent smokers. Six acute myocardial infarctions and 8 strokes occurred during a median follow-up of 66.0 months. Persistent smoking was associated with an increased risk of events (P<0.001). CONCLUSIONS: Smoking is associated with upregulated MTFA and progression of CIMT, which may be related to the risk of atherothrombotic events in MetS patients.
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Kohashi et al. (2017) conducted a cohort in Metabolic syndrome (n=301). Persistent smoking vs. Never smokers, past smokers, and quitters was evaluated on Atherothrombotic events (acute myocardial infarction and stroke) (HR 3.20, 95% CI 1.02-10.12, p=0.048). Persistent smoking significantly increased the risk of atherothrombotic events (HR 3.20) and was associated with upregulated monocyte tissue factor activity and progression of carotid atherosclerosis in patients with metabolic syndrome.
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