Unit:
Τομέας ΠαθολογίαςLibrary of the School of Health Sciences
Author:
Marinou Margarita-Christina
Dissertation committee:
Ιωάννης Λεκάκης, Καθηγητής, Ιατρική, ΕΚΠΑ
Ευστάθιος Ηλιοδρομίτης, Καθηγητής, Ιατρική, ΕΚΠΑ
Ιωάννης Παρασκευαίδης, Καθηγητής, Ιατρική, ΕΚΠΑ
Βάια Λαμπαδιάρη, Αναπληρώτρια Καθηγήτρια, Ιατρική, ΕΚΠΑ
Ιωάννης Παρίσης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Αθανάσιος Ράπτης, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Κίμωνας Σταματελόπουλος, Αναπληρωτής Καθηγητής, Ιατρική, ΕΚΠΑ
Original Title:
Η επίδραση της διακοπής του καπνίσματος με τη χορήγηση φαρμακευτικών σκευασμάτων στις ιδιότητες του αρτηριακού τοιχώματος και στον ενδοθηλιακό γλυκοκάλυκα σε καπνιστἐς που εντάσσονται σε πρόγραμμα διακοπής καπνίσματος
Translated title:
The effects of medically-aided smoking cessation on vascular function and oxidative stress are not fully clarified.
Summary:
Methods: One hundred eighty-eight current smokers were randomized to varenicline or nicotine replacement treatment (NRT) for a 3-month period. We assessed: (a) augmentation index (Aix) and pulse wave velocity (PWV); (b) perfusion boundary region (PBR) of sublingual microvasculature (range:5 e25 mm), an index of the endothelial glycocalyx thickness, using Sideview, Darkfield imaging; (c) the exhaled CO; and (d) the malondialdehyde (MDA) and protein carbonyls (PC) plasma levels, as markers of oxidative stress, at baseline and after 3 and 12 months.
Results: After 3 months of treatment, CO, MDA, PC and Aix were decreased in all subjects (median CO: 25 vs. 6 ppm, MDA: 0.81 vs. 0.63 nmol/L, PC: 0.102, vs. 0.093 nmol/mg protein, Aix: 13% vs. 9%, p < 0.05) while PWV remained unchanged. Endothelial glycocalyx integrity showed a greater improvement in the varenicline than the NRT treatment (PBR range 5e9 mm: 1.07 ± 0.02 vs. 1.17 ± 0.02 mm, p ¼ 0.03) in
parallel with the greater CO reduction (5 vs. 7 ppm, p ¼ 0.02). At 1-year follow-up, MDA, PC, Aix and PBR at 5e25 mm range were further improved in subjects who abstained from smoking (n ¼ 84 out of 188), while the above markers and PWV deteriorated in relapsed smokers (p < 0.05).
Conclusions: A smoking cessation program using varenicline or NRT for 3 months resulted in a decrease of CO, oxidative stress, arterial stiffness and restored endothelial glycocalyx. These effects were more evident after varenicline treatment, likely because of a greater CO reduction, and were maintained after 1 year only in subjects who abstained from smoking.
Conclusions
A 3-month smoking cessation programme, using either varenicline or NRT, resulted in a decrease of exhaled CO levels, improved arterial elasticity and reduced of oxidative stress in all participants.
Varenicline treatment resulted in a greater improvement of endothelial glycocalyx thickness than NRT, likely because of the more effective reduction of exhaled CO concentrations. At 12 months of follow-up, vascular properties and oxidative stress remained improved in subjects who abstained from smoking while deteriorated in relapsed smokers.
Main subject category:
Health Sciences
Keywords:
Effects of medically-aided smoking, Cessation, Vascular function , Oxidative stress, Pulse wave velocity, Ugmentation index
Number of references:
161
