Anti- and pro-oxidant factors and endothelial dysfunction in chronic cigarette smokers with coronary heart disease

BackgroundEndothelial dysfunction in cigarette smokers has been ascribed to increased oxidative damage. The aims of the present study were to compare the endothelial function of normotensive smokers with that of non-smokers and to examine its relation to some parameters representative of oxidative damage and of antioxidant capacity.MethodsWe investigated 32 chronic smokers (15–30 cigarettes daily) affected by coronary heart disease, ranging from acute myocardial infarction to instable angina pectoris, and 28 matched non-smokers without any definite risk factors. All subjects underwent assessment of nitric oxide (NO)-dependent endothelial function, measured as brachial artery vasodilatation in response to reactive ischemia, using a standardized echographic method. Plasma and urinary levels of NO were also measured in all subjects, as were urinary 15-isoprostane F2t, plasma serum lipids, homocysteine (Hcy), ascorbic acid, retinol, tocopherol, and alpha- and beta-carotene (by high-performance liquid chromatography).ResultsSmokers showed a significantly lower NO-mediated vasodilatation response (3.50% vs. 6.18%, p < 0.001) and higher levels of urinary NO metabolites and 15-isoprostane F2t. They also had higher levels of Hcy (p < 0.001); these values were significantly and inversely related to NO serum levels (r = − 0.512, p < 0.001). Moreover, smokers had a significant and corresponding reduction in circulating levels of ascorbic acid, tocopherol, and alpha- and beta-carotene.ConclusionsThe present study shows a clear relation between endothelial dysfunction (NO production impairment) and cigarette smoking, especially in the presence of high levels of LDL-cholesterol. It also defines some markers of both oxidative damage and antioxidant protective capacity in this condition. The monitoring of these factors may be advisable in order to assess the amount of endothelial damage.