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

• Published in: Atherosclerosis Vol. 102; no. 2; pp. 155 - 162
• Main Authors: Smith, F.B., Lowe, G.D.O., Fowkes, F.G.R., Rumley, A., Rumley, A.G., Donnan, P.T., Housley, E.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01.09.1993; Elsevier
• Subjects: Aged; Arteriosclerosis - blood; Atherosclerosis (general aspects, experimental research); beta-Thromboglobulin - analysis; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Case-Control Studies; Endothelium; Female; Fibrin Fibrinogen Degradation Products - analysis; Fibrinogen; Fibrinogen - analysis; Fibrinolysis; Hemostasis - physiology; Humans; Lipid peroxides; Lipid Peroxides - blood; Male; Medical sciences; Middle Aged; Peripheral atherosclerosis; Peripheral Vascular Diseases - blood; Plasminogen Inactivators - blood; Random Allocation; Smoking; Smoking - adverse effects; von Willebrand Factor - analysis; Peripheral atherosclerosis; Fibrinolysis; Fibrinogen; Smoking; Endothelium; Lipid peroxides; Human; Tobacco smoking; Lower limb; Cardiovascular disease; Lipids; Vascular disease; Atherosclerosis; Risk factor; Arterial disease of the limb; Arterial occlusive disease; Peroxidation
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/0021-9150(93)90157-P

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.