on January 15, 2004
Published online before print January 15, 2004, doi: 10.1161/01.ATV.0000116863.37311.82
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Submitted on August 19, 2003
Accepted on November 11, 2003
Risk of Myocardial Infarction and Stroke in Smokers Is Related to Plasma Levels of Inflammation-Sensitive Proteins
P. Lind *;
From the Departments of Internal Medicine (P.L., L.S.), Community Medicine (G.E., L.J., B.H.), and Vascular Diseases (F.L.), Malmö University Hospital, Malmö, Sweden.
* To whom correspondence should be addressed. E-mail: Peter.C.Lind{at}skane.se.
Background--The extent to which differences in cardiovascular risk between smokers with similar daily tobacco consumption may be related to plasma levels of inflammation-sensitive proteins (ISP) and whether these proteins are associated with levels of carboxyhemoglobin (COHb%) have not been clarified.
Methods and Results--In a population-based cohort of 1489 never smokers, 1685 former smokers, and 2901 current smokers, aged 28 to 61 years, plasma levels of orosomucoid (
1-acid glycoprotein), 1-antitrypsin, haptoglobin, fibrinogen, and ceruloplasmin were measured. CoHb% levels were available for 2098 of them. Incidence of myocardial infarction, stroke, and death were monitored over 18.7±4.7 years. The proportion with high ISP levels (ie, 
2 ISPs in the top quartile) increased progressively with daily tobacco consumption (P<0.01) and COHb% (P<0.01). In all smoking categories, the incidence of stroke, cardiac events, and death was related to ISP. In heavy smokers, high ISP levels were associated with adjusted relative risks of 1.57 (1.05 to 2.35) and 1.50 (1.11 to 2.03) for cardiac events and death, respectively. Corresponding figures for moderate and light smokers were 1.59 (1.13 to 2.24) and 1.14 (0.87 to 1.49), respectively, and 1.32 (0.95 to 1.85) and 1.48 (1.10 to 1.98), respectively.
Conclusion--ISP levels are related to COHb% in smokers. High levels are associated with an increased cardiovascular risk.
Key words: stroke • myocardial infarction • smoking • inflammation • plasma proteins • epidemiology
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