I.F. Cieri1, A. Rodriguez1, L. Morena1, S. Patel1, S. Ghandour1, I. Lee1, E. Young1, A. Dua1 1Massachusetts General Hospital, Vascular Surgery, Boston, MA, USA
Introduction: Cigarette smoke exposure can increase the risk of arterial blood clots and cardiovascular mortality. Compounds in smoke, such as acrolein, accelerate the development of atherosclerosis within arteries and worsen peripheral artery disease (PAD). The impact of cigarette smoke on platelet aggregation has not been quantified; hence, the aim of this study was to delineate differences in platelet reactivity between smokers and non-smokers using Thromboelastography (TEG). TEG is a comprehensive hemostatic assay that assesses the overall viscoelastic characteristics of clot formation in whole blood, particularly under minimal shear stress conditions.
Methods: From December 2020 to February 2024, individuals diagnosed with PAD who underwent revascularization were prospectively evaluated. Participants were divided into two groups: current and former smokers combined versus non-smokers. An unpaired t-test with Weich correction was used to analyze the impact of tobacco on measured values among TEG participants.
Results: An analysis was conducted on a cohort of 307 individuals, with 20% being non-smokers and 80% classified as current or former smokers. The findings revealed significant statistical variances (p<0.05) in AA% aggregation, ADP MA, CK MA, and HKH MA, indicating lower measured values among smokers as opposed to non-smokers. Interestingly, smokers exhibited higher values in AA% inhibition. The findings showed that tobacco use had the greatest impact (p<0.05), resulting in decreased measurements of AA MA, ActF MA, CFF FLEV, CFF MA, CFF Max amplitude, CRT MA, and CRT max amplitude. However, no statistically significant differences were observed in ADP % aggregation, ADP % inhibition, CK K (min), CK R (min), or CKH R (min).
Conclusion: Our study identifies significant differences in coagulation parameters between smokers and non-smokers, indicating decreased values among smokers, particularly in AA MA, ActF MA, and CRT MA. These findings emphasize the clinical significance of tobacco's impact on hemostatic parameters, potentially influencing coagulation dynamics and patient care.