title: Smoking and lipoprotein abnormalities on platelet aggregation in coronary heart disease.
abstract: This study aimed to clarify whether smoking had any influence on platelet aggregability in coronary patients with different lipoprotein abnormalities. We studied 297 non-diabetic patients with coronary heart disease, 40 to 85 years of age, 223 (75%) male, 167 smokers and 130 never smokers. After 3 months on Step-One diet, without any regular medication, patients had fasting plasma total cholesterol levels > or = 6.2 mmol/L; low-density lipoprotein > or = 4.14 mmol/L; and different levels of high-density lipoprotein and triglycerides. Platelet aggregation was analyzed by turbidometric method of Born. Patients were classified in groups of smokers and non-smokers. Results showed that platelet hyperaggregability was more prevalent in smokers with lower levels of high-density lipoprotein (47% vs. 20%; P=0.004 for spontaneous platelet aggregation, 56% vs. 33%; P=0.02 for adenosine diphosphate induced platelet aggregation), and in smokers with hypertrygliceridemia (64% vs. 29%; P=0.004 for spontaneous, 81% vs. 43%; P<0.0001 for adenosine diphosphate induced, and 87% vs. 46%; P<0.0001 for adrenaline induced platelet aggregation). Platelet hypoaggregability was greater in non-smokers with normal high-density lipoprotein and triglycerides plasma levels when compared to non-smokers with the same lipid profile (39% vs. 12%; P=0.004). In conclusion, smoking increased platelet reactivity in hypercholesterolemic patients with low high-density lipoprotein levels or high triglycerides levels.
authors.affiliation: Heart Institute Clinical Department, São Paulo, Brazil.
authors.forename: A
authors.initials: A
authors.lastname: de Padua Mansur
authors.forename: B
authors.initials: B
authors.lastname: Caramelli
authors.forename: C B
authors.initials: CB
authors.lastname: Vianna
authors.forename: D
authors.initials: D
authors.lastname: Chamone
authors.forename: J A
authors.initials: JA
authors.lastname: Ramires
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001791:Blood Platelet Disorders / Q000209:etiology / Q000503:physiopathology*; D003327:Coronary Disease / Q000209:etiology / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications*; D008297:Male; D008875:Middle Aged; D010974:Platelet Aggregation; D010979:Platelet Function Tests; D012907:Smoking / Q000009:adverse effects*