title: Smoking and atherosclerotic cardiovascular disease: part II: role of cigarette smoking in cardiovascular disease development.
abstract: Potential mechanisms and biomarkers of atherosclerosis related to cigarette smoking - a modifiable risk factor for that disease - are discussed in this article. These include smoking-associated inflammatory markers, such as leukocytes, high-sensitivity C-reactive protein, serum amyloid A, ICAM-1 and IL-6. Other reviewed markers are indicative for smoking-related impairment of arterial endothelial function (transcapillary leakage of albumin, inhibition of endogenous nitric oxide synthase activity and reduced endothelium-dependent vasodilation) or point to oxidative stress caused by various chemicals (cholesterol oxidation, autoantibodies to oxidized low-density lipoprotein, plasma levels of malondialdehyde and F(2)-isoprostanes and reduced antioxidant capacity). Smoking enhances platelet aggregability, increases blood viscosity and shifts the pro- and antithrombotic balance towards increased coagulability (e.g., fibrinogen, von Willebrand factor, ICAM-1 and P-selectin). Insulin resistance is higher in smokers compared with nonsmokers, and hemoglobin A1c is dose-dependently elevated, as is homocysteine. Smoke exposure may influence the kinetics of markers with different response to transient or chronic changes in cigarette smoking behavior.
authors.affiliation: Clinical Research Institute, Center for Cardiovascular Diseases, Heinz-Meise-Strasse 100, 36199 Rotenburg an der Fulda, Germany. sbu135@live.com
authors.forename: Martin
authors.initials: M
authors.lastname: Unverdorben
authors.forename: Klaus
authors.initials: K
authors.lastname: von Holt
authors.forename: Bernhard R
authors.initials: BR
authors.lastname: Winkelmann