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Alterations in the Coagulation System of Active Smokers from the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study

  • G. Delgado
  • R. Siekmeier
  • T. B. Grammer
  • B. O. Boehm
  • W. März
  • M. E. KleberEmail author
Chapter
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 832)

Abstract

Smoking is an important and preventable risk factor of cardiovascular diseases with effects on blood coagulation. Our aim was to analyze the influence of smoking on coagulation parameters. Concentrations or activities of blood coagulation factors were compared in 777 active smokers and 1,178 lifetime non-smokers of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. The association with mortality was examined using Cox regression. The findings show that AS had a tendency toward thrombosis. They displayed significantly higher values for fibrinogen, soluble fibrinogen, factor XIII, and tissue factor pathway inhibitor; whereas FVII, FVIII, FXII, von Willebrand factor (vWF), and thrombomodulin were decreased. The Cox regression analysis showed fibrinogen, FVIII, vWF, thrombomodulin, and tissue factor pathway inhibitor to be independent risk factors for mortality in active smokers with hazard ratios of 1.16 (95 % CI: 1.02–1.31), 1.40 (1.22–1.59), 1.37 (1.22–1.56), 1.19 (1.07–1.31), and 1.22 (1.06–1.40) per increase of one standard deviation. We conclude that active smokers have an increased thrombogenic potential associated with significant changes in the coagulation system. Individual parameters of the coagulation system are independent predictors of mortality. Therefore, parameters of the coagulation system, apart from other risk factors for cardiovascular disease (e.g., lipids or life-style) should be determined for risk prediction in active smokers.

Keywords

Cardiovascular disease Hemostasis Mortality Smoking Thrombosis 

Notes

Acknowledgements

We extend our appreciation to the participants of the LURIC study; without their collaboration, this article would not have been written. We thank the LURIC study team who were either temporarily or permanently involved in patient recruitment as well as sample and data handling, in addition to the laboratory staff at the Ludwigshafen General Hospital and the Universities of Freiburg and Ulm, Germany. LURIC has received funding from the 6th Framework Program (integrated project Bloodomics, grant LSHM-CT-2004-503485) and from the 7th Framework Program (Atheroremo, grant agreement number 201668 and RiskyCAD, grant agreement number 305739) of the European Union.

Conflicts of Interest

The authors declare no conflicts of interest in relation to this article.

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Copyright information

© Springer International Publishing Switzerland 2014

Authors and Affiliations

  • G. Delgado
    • 1
  • R. Siekmeier
    • 2
  • T. B. Grammer
    • 1
  • B. O. Boehm
    • 3
    • 4
  • W. März
    • 1
    • 5
    • 6
  • M. E. Kleber
    • 1
    Email author
  1. 1.Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of MannheimHeidelberg UniversityMannheimGermany
  2. 2.Drug Regulatory AffairsUniversity of BonnBonnGermany
  3. 3.Division of Endocrinology, Department of MedicineUniversity HospitalUlmGermany
  4. 4.LKC School of MedicineImperial College London and Nanyang Technological UniversitySingaporeSingapore
  5. 5.Clinical Institute of Medical and Chemical Laboratory DiagnosticsMedical University GrazGrazAustria
  6. 6.Synlab Academy, Synlab Services GmbHMannheimGermany

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