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Short-term effects of the smoke-free legislation on haemostasis and systemic inflammation due to second hand smoke exposure

Journal: Thrombosis and Haemostasis
ISSN: 0340-6245
DOI: https://doi.org/10.1160/TH11-02-0062
Issue: 2011: 105/6 (June) pp. 933–1123
Pages: 1024-1031

Short-term effects of the smoke-free legislation on haemostasis and systemic inflammation due to second hand smoke exposure

The AERER study

G. Cayla (1), P. Sié (2), J. Silvain (1), D. Brugier (1), J.-P. Cambou (3), D. Thomas (1), A. Pena (1), S. A. O’Connor (1), A. Bura (3), J.-B. Ruidavets (4), G. Montalescot (1), J.-P. Collet (1)

(1) Institut de Cardiologie, INSERM_UMR_937, Pitié-Salpêtrière University Hospital (AP-HP), Université Paris 6, Paris, France; (2) Toulouse Laboratory of Haematology, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC) INSERM 1048, CHU de Toulouse and Université Paul Sabatier, Toulouse, France; (3) University of Toulouse, Rangueil University Hospital, Dept. of Vascular Medicine, Toulouse, France; (4) Department of Epidemiology, Health Economics and Public Health, UMR 558 INSERM, Université de Toulouse, CHU de Toulouse, Toulouse, France

Keywords

platelet reactivity, Second hand smoke, smoke-free legislation, fibrin-clot, inflammatory biomarkers

Summary

It was the objective of this study to assess the effect of the implementation of the smoke-free legislation on haemostasis and systemic inflammation in second-hand smoking (SHS)-exposed healthy volunteers. Fibrin-rich clot properties, platelet reactivity and inflammatory biomarkers were measured before and four months following the implementation of the smoke-free legislation in gender and age-matched healthy volunteers exposed (n=23, exposed) and unexposed (n=23, controls) to occupational SHS. The primary objective was to compare fibrin-rich clot stiffness before and after implementation of the smoke-free legislation. There was 40% reduction in fibrin-rich clot stiffness following the implementation of the smoke-free legislation in SHS-exposed volunteers (17 ± 7 vs. 10.6 ± 7 dynes/cm², before and after, respectively, p=0.001). These dramatic changes were associated with a 20% reduction in fibrin fiber density (p<0.01) and a 20% reduction in clot lysis time (p=0.05). No change in fibrin properties was observed in the control group of SHS-unexposed volunteers related to the implementation of the smoke-free legislation. Of interest, neither platelet reactivity nor systemic inflammatory biomarkers were changed in either group. The smoke-free legislation is associated with significant changes in fibrin-rich clot properties toward a less thrombogenic conformation with a better fibrinolysis response while neither platelet reactivity nor systemic inflammatory biomarkers are modified. These improvements may explain the observed reduction in acute coronary syndrome following the implementation of the smoke-free legislation.

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