Key result
Smoking cessation with nicotine replacement therapy significantly reduced the mean augmentation index from 23.4% at baseline to 13.9% at 56 days (p < 0.001).
Why the study?
Does smoking cessation with nicotine replacement therapy improve arterial stiffness in long-term smokers?
Observational (n=26)
Does smoking cessation with nicotine replacement therapy improve arterial stiffness in long-term smokers?
Smoking cessation supported by nicotine replacement therapy leads to an early improvement in peripheral vascular tone, as indicated by a reduction in augmentation index.
May support early vascular benefits from smoking cessation with NRT; leaves open causality and clinical outcome impact pending randomized trials.
OBJECTIVES: Cigarette smoking induces cardiovascular pathology and worsens arterial stiffness. Arterial stiffness can be assessed noninvasively based on 2 indices: pulse-wave velocity (PWV), indicating aortic stiffness, and the augmentation index (AIx), indicating aortic wave reflection. The impact of smoking cessation (SC) with nicotine replacement therapies (NRT) on arterial stiffness remains unknown. METHODS: AIx and PWV were studied prospectively (using a SphygmoCor system) in 26 long-term smokers (>10 cigarettes/day; mean age 43 ± 6 years) before (visit 1) and 28 and 56 days (visit 2 and visit 3) after SC supported by NRT. Abstinence was ascertained when exhaled carbon monoxide (CO) was <10 ppm; the quantity of NRT absorbed was assessed based on the serum cotinine level. RESULTS: Sixteen of 24 patients (67%) were abstinent at the end of the study; 8/24 had cut down on smoking, and 2 were lost to follow-up. CO and serum cotinine levels fell after SC. The mean AIx for the population as a whole was 23.4% at visit 1, with a significant early reduction by visit 2 (16.2%) and visit 3 (13.9%) (ANOVA, p < 0.001). The PWV, peripheral blood pressure, and heart rate were unchanged. CONCLUSIONS: The improvement in AIx and the stability of PWV after SC with NRT indicate improved peripheral vascular tone. This impact may account for the early clinical benefit of SC observed even when associated with NRT.
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Roux et al. (2010) conducted an observational in Long-term smokers (n=26). Smoking cessation with nicotine replacement therapy vs. Baseline (before smoking cessation) was evaluated on Augmentation index (AIx) (p=<0.001). Smoking cessation with nicotine replacement therapy significantly reduced the mean augmentation index from 23.4% at baseline to 13.9% at 56 days (p < 0.001).
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