Smoking and Acute Myocardial Infarction Mechanisms

Tobacco smoke is a complex mixture of aerosols and particulate matter containing about 4000 different chemical compounds of which many are highly toxic and more than 40 are carcinogenic.

Tobacco smoke interferes with the cardiovascular system in the following ways: Smoking increases the risk of thrombosis by increasing platelet aggregation, blood viscosity, and fibrinogen levels. C-reactive protein, a marker of inflammation, is also increased by cigarette smoking. The inhaled carbon monoxide produces carboxyhemoglobin, which leads to an imbalance between oxygen demand of and supply to the myocardium. Polycyclic aromatic hydrocarbons (PAH) and other toxic compounds damage the endothelium. LDL cholesterol is oxidized by cigarette smoke and it is the oxidized LDL cholesterol which exerts its atherogenic effect. VLDL cholesterol and triglycerides are also increased by inhaled cigarette smoke. In addition, cigarette smoke decreases the protective HDL cholesterol.

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