Acute systemic and coronary hemodynamic and serologic responses to cigarette smoking in long-term smokers with atherosclerotic coronary artery disease

Previous studies suggested that cigarette smoking 1) inhibits an increase in coronary blood flow that should occur with increased myocardial oxygen demands, and 2) alters thromboxane and prostacyclin production, causing vasoconstriction and platelet aggregation. In 38 smokers (26 men and 12 women, aged 50 +/- 8 years [mean +/- standard deviation] ) with coronary artery disease, systemic and coronary hemodynamic and serologic variables were measured before and after smoking two cigarettes (in 8 to 10 minutes) (21 patients) or 8 to 10 minutes without smoking (17 patients; control group). No variable changed in the control group. Smoking increased (p less than 0.05) heart rate-systolic pressure product, cardiac output and maximal first derivative of left ventricular pressure (dP/dt) without significantly changing the coronary sinus concentrations of thromboxane B2 or 6-keto-prostaglandin F1 alpha (the stable metabolites of thromboxane A2 and prostacyclin, respectively). Smoking did not increase coronary flow in 6 of 11 patients with greater than 70% stenosis of the proximal left anterior descending or circumflex coronary artery, or both, whereas it caused an increase in coronary flow in all 10 patients without proximal stenoses (p = 0.006). To determine if smoking altered the response of coronary flow to increased myocardial oxygen demands, 10 smokers (5 men and 5 women, aged 48 +/- 9 years) underwent atrial pacing for 5 minutes followed 15 minutes later by atrial pacing for 5 minutes during smoking. In the five patients without proximal left coronary artery stenoses, coronary flow increased 26 +/- 29 ml/min with pacing and 45 +/- 21 ml/min with pacing/smoking (p = 0.018).(ABSTRACT TRUNCATED AT 250 WORDS)

This article has been cited by other articles:

				I. Barutcu, A. M. Esen, D. Kaya, E. Onrat, M. Melek, A. Celik, C. Kilit, M. Turkmen, O. Karakaya, O. B. Esen, et al. Effect of Acute Cigarette Smoking on Left and Right Ventricle Filling Parameters: A Conventional and Tissue Doppler Echocardiographic Study in Healthy Participants Angiology, July 1, 2008; 59(3): 312 - 316. [Abstract] [PDF]

				I. Goldenberg, M. Jonas, A. Tenenbaum, V. Boyko, S. Matetzky, A. Shotan, S. Behar, and H. Reicher-Reiss Current Smoking, Smoking Cessation, and the Risk of Sudden Cardiac Death in Patients With Coronary Artery Disease Arch Intern Med, October 27, 2003; 163(19): 2301 - 2305. [Abstract] [Full Text] [PDF]

				H. Hioki, N. Aoki, K. Kawano, M. Homori, Y. Hasumura, T. Yasumura, A. Maki, H. Yoshino, A. Yanagisawa, and K. Ishikawa Acute effects of cigarette smoking on platelet-dependent thrombin generation Eur. Heart J., January 1, 2001; 22(1): 56 - 61. [Abstract] [PDF]

				A. R. Yataco, A. W. Gardner, and A. W. Gardner Acute Reduction in Ankle/Brachial Index Following Smoking in Chronic Smokers with Peripheral Arterial Occlusive Disease Angiology, May 1, 1999; 50(5): 355 - 360. [Abstract] [PDF]

				S. Sugiyama, K. Kugiyama, M. Ohgushi, T. Matsumura, Y. Ota, H. Doi, N. Ogata, H. Oka, and H. Yasue Supersensitivity of atherosclerotic artery to constrictor effect of cigarette smoke extract Cardiovasc Res, May 1, 1998; 38(2): 508 - 515. [Abstract] [Full Text] [PDF]

				D. Waters, J. Lesperance, P. Gladstone, S. J. Boccuzzi, T. Cook, R. Hudgin, G. Krip, and L. Higginson Effects of Cigarette Smoking on the Angiographic Evolution of Coronary Atherosclerosis: A Canadian Coronary Atherosclerosis Intervention Trial (CCAIT) Substudy Circulation, August 15, 1996; 94(4): 614 - 621. [Abstract] [Full Text]

				J. Hung, J. Y.T. Lam, L. Lacoste, and G. Letchacovski Cigarette Smoking Acutely Increases Platelet Thrombus Formation in Patients With Coronary Artery Disease Taking Aspirin Circulation, November 1, 1995; 92(9): 2432 - 2436. [Abstract] [Full Text]

				J. Czernin, K. Sun, R. Brunken, M. Bottcher, M. Phelps, and H. Schelbert Effect of Acute and Long-term Smoking on Myocardial Blood Flow and Flow Reserve Circulation, June 15, 1995; 91(12): 2891 - 2897. [Abstract] [Full Text]

				D. J. Moliterno, J. E. Willard, R. A. Lange, B. H. Negus, J. D. Boehrer, D. B. Glamann, C. Landau, J. D. Rossen, M. D. Winniford, and L. D. Hillis Coronary-Artery Vasoconstriction Induced by Cocaine, Cigarette Smoking, or Both N. Engl. J. Med., February 17, 1994; 330(7): 454 - 459. [Abstract] [Full Text]

				J. J. Bergan, S. E. Wilson, G. Wolf, and R. H. Deupree Unexpected, Late Cardiovascular Effects of Surgery for Peripheral Artery Disease Arch Surg, September 1, 1992; 127(9): 1119 - 1124. [Abstract] [PDF]

				R. A. Lange, R. G. Cigarroa, E. D. Flores, W. McBride, A. S. Kim, P. J. Wells, J. B. Bedotto, R. S. Danziger, and L. D. Hillis Potentiation of Cocaine-Induced Coronary Vasoconstriction by Beta-Adrenergic Blockade Ann Intern Med, June 15, 1990; 112(12): 897 - 903. [Abstract] [PDF]