The Impact of Smoking on Platelet Indices Among Acute Myocardial Infarction Patients

Abstract

Purpose: The purpose of this study is to investigate the impact of smoking on platelet indices among patients with acute myocardial infarction (AMI), and to highlight comparative dimensions between smokers and non-smokers. Materials and Methods: A patient diagnosed with AMI and scheduled for coronary angiography between November 2023 and March 2024 was included in this study. Participants were divided into two groups based on their smoking status. Platelet indices, including platelet count, mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT), were compared. Subsequently, the smoking patients were categorized into five groups based on their smoking duration. Results: In the study, which included 224 patients, MPV values in the NSTEMI group among non-smokers were found to be significantly higher compared to the STEMI group (p=0.013). When the relationship between smoking duration and platelet indices was analyzed, it was observed that with increasing smoking duration, platelet indices significantly decreased (p<0.001), platelet count increased (p<0.001), PDW decreased (p=0.02), PCT increased (p=0.001), and MPV decreased (p=0.002). Conclusion: The findings indicate that smoking has significant effects on platelet indices in AMI patients. Particularly, changes in platelet functions associated with increased duration of smoking are of importance for the progression of cardiovascular diseases and the increase in thrombogenic risk. These results highlights the need for a deeper understanding of the effects of smoking on platelet function and the consideration of these effects in the management of cardiovascular risk.

Keywords

• acute coronary syndrome
• cardiovascular risk
• platelet function
• tobacco

Akut Miyokard Enfarktüsü Hastaları Arasında Sigara İçmenin Trombosit İndeksleri Üzerine Etkisi

Abstract

Amaç: Bu çalışmanın amacı, akut miyokard infarktüsü (AMI) hastaları arasında sigara içmenin trombosit indeksleri üzerindeki etkisini incelemek ve sigara içenler ile içmeyenler arasındaki karşılaştırmalı boyutları vurgulamaktır. Araçlar ve Yöntem: Kasım 2023- Mart 2024 tarihleri arasında koroner anjiyografi planlanan AMI hastası bu çalışmaya dahil edilmiştir. Katılımcılar sigara içme durumlarına göre iki gruba ayrılmıştır. Trombosit indeksi, trombosit sayısı, ortalama trombosit hacmi (MPV), trombosit dağılım genişliği (PDW) ve trombokrit (PCT) değerleri karşılaştırılmıştır. Daha sonra sigara içen hastalar sigara içme sürelerine göre beş gruba ayrılmıştır. Bulgular: 224 hastanın dahil edildiği çalışmada sigara içmeyenler arasında, NSTEMI grubunda MPV değerleri, STEMI grubuna göre anlamlı derecede yüksek bulunmuştur (p=0.013). Sigara içme süresi ile trombosit indeksleri arasındaki ilişki incelendiğinde, artan sigara içme süresi ile trombosit indeksi anlamlı olarak azalmıştır (p<0.001), trombosit sayısı artmıştır (p<0.001), PDW azalmıştır (p=0.02), PCT artmıştır (p=0.001) ve MPV azalmıştır (p=0.002). Sonuç: Sigara içmenin AMI hastalarında trombosit indeksleri üzerinde önemli etkilere sahip olduğunu göstermektedir. Özellikle, sigara içme süresinin artması ile trombosit fonksiyonlarındaki değişiklikler, kardiyovasküler hastalıkların ilerlemesi ve trombojenik riskin artışı açısından önem taşımaktadır. Bu sonuçlar, sigara içmenin trombosit üzerindeki etkilerinin daha derinlemesine anlaşılması ve kardiyovasküler risk yönetiminde dikkate alınması gerektiğini vurgulamaktadır.

Keywords

• akut koroner sendrom
• kardiyovasküler risk
• trombosit fonksiyonu
• tütün

References

1. 1. Leong DP, Joseph PG, McKee M, et al. Reducing the global burden of cardiovascular disease, part 2: prevention and treatment of cardiovascular disease. Circ. Res. 2017;121(6):695-710.
2. 2. Bhatnagar A. Environmental determinants of cardiovascular disease. Circ. Res. 2017;121(2):162-180.
3. 3. Scridon A. Platelets and their role in hemostasis and thrombosis-From physiology to pathophysiology and therapeutic implicationsInt. J. Mol. Sci. 2022;23(21): 12772.
4. 4. Kang MG, Koo B-K, Tantry US, et al. Association between thrombogenicity indices and coronary microvascular dysfunction in patients with acute myocardial infarction. JAAC. 2021;6(9):749-761.
5. 5. Csordas A, Bernhard D. The biology behind the atherothrombotic effects of cigarette smoke. Nat. Rev. Cardiol. 2013;10(4):219-230.
6. 6. Swiger KJ, Yousuf O, Bliden KP, Tantry US, Gurbel PA. Cigarette smoking and clopidogrel interaction. urr. Cardiol. Rep. 2013;15:1-10.
7. 7. Costa SC, de Matos Vinagre CG, Chacra APM, de Azevedo MRA. Platelet indices in patients with acute coronary syndrome. JBM. 2015;3(11):71.
8. 8. Al-Obeidi SRH, Ahmedm SH, Obeid FA. Evaluation of platelet indices in patients with acute coronary syndrome. Mustansiriya Med. J. 2013;12(1):59.

9. 9. Pujani M, Chauhan V, Singh K, Rastogi S, Agarwal C, Gera K. The effect and correlation of smoking with platelet indices, neutrophil lymphocyte ratio and platelet lymphocyte ratio. Hematol Transfus Cell Ther. 2021;43(4):424-429.
10. 10. Hlapčić I, Somborac-Bačura A, Popović-Grle S, et al. Platelet indices in stable chronic obstructive pulmonary disease–association with inflammatory markers, comorbidities and therapy. Biochem. Med. 2020;30(1):60-73.
11. 11. Turk U, Tengiz I, Ozpelit E, et al. The relationship between platelet indices and clinical features of coronary artery disease. Kardiol. Pol. (Pol Heart J). 2013; 71(11):1129-1134.
12. 12. Ghahremanfard F, Semnani V, Ghorbani R, Malek F, Behzadfar A, Zahmatkesh M. Effects of cigarette smoking on morphological features of platelets in healthy men. Saudi Med. J. 2015;36(7):847.
13. 13. Wang XL. Molecular mechanisms of tobacco-induced diseases. Nova Publishers; 2005.
14. 14. Barua RS, Rigotti NA, Benowitz NL, et al. 2018 ACC expert consensus decision pathway on tobacco cessation treatment: a report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol. 2018;72(25):3332-3365.
15. 15. MacCallum PK. Markers of hemostasis and systemic inflammation in heart disease and atherosclerosis in smokers. Proc Am Thorac Soc. 2005;2(1):34-43.
16. 16. Varol E, Icli A, Kocyigit S, Erdogan D, Ozaydin M, Dogan A. Effect of smoking cessation on mean platelet volume. Clin Appl Thromb Hemost. 2013;19(3): 315-319.