Archives of the Turkish Society of Cardiology
High levels of high-sensitivity C-reactive protein and impaired autonomic activity in smokers [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2008; 36(6): 368-375

High levels of high-sensitivity C-reactive protein and impaired autonomic activity in smokers

Ömer Alyan1, Fehmi Kaçmaz2, Özcan Özdemir3, Zülküf Karahan1, Tuncay Taşkesen1, Hikmet İyem4, Sait Alan1, Aziz Karadede1, Erdoğan İlkay5
1Department Of Cardiology, Dicle University, Diyarbakir, Turkey
2Bingol State Hospital, Cardiology Clinic, Bingol, Turkey
3Akay Hospital, Cardiology Clinic, Ankara, Turkey
4Department Of Cardiovascular Surgery, Dicle University, Diyarbakir, Turkey
5Mesa Hospital, Cardiology Clinic, Ankara, Turkey


OBJECTIVES
We investigated the relationship between high sensitivity C-reactive protein (hs-CRP) activity and autonomic nervous activity using heart rate variability in smokers.

STUDY DESIGN
The study consisted of 136 healthy subjects, including 66 smokers (35 women, 31 men; mean age 36 years) and 70 nonsmokers (43 women, 27 men; mean age 34 years). Serum samples were collected from all the subjects. Three-channel, 24-hr Holter monitoring was performed to derive the mean heart rate, standard deviation of normal NN intervals (SDNN), standard deviation of 5-minute mean NN intervals (SDANN), root mean square differences of successive NN intervals (RMSSD), high- (HF) and low- (LF) frequency power components, and the LF/HF ratio.

RESULTS
In smokers, the mean duration of smoking was 13.6±8.2 years (range 3 to 45 years), and the mean number of cigarettes consumed per day was 16.3±7.1 (range 5 to 40). Smokers exhibited significantly higher mean heart rate, hs-CRP and fibrinogen levels, mean platelet volume, white blood cell count, LF, and LF/HF ratio, with significantly lower SDNN, SDANN, RMSSD, and HF values. In smokers, hs-CRP was correlated with the number of cigarettes consumed per day, duration of smoking, fibrinogen level, mean platelet volume, white blood cell count, LF, and LF/HF ratio, and inversely correlated with HF, SDNN, and SDANN. Even smoking a single cigarette resulted in an acute, 0.07-fold increase in the hs-CRP level (p<0.0001). In linear regression analysis, both the number of cigarettes consumed per day (=0.52, p=0.011) and duration of smoking (=0.073, p<0.0001) had an independent effect on the hs-CRP level.

CONCLUSION
Smoking both impairs the sympathovagal balance and increases the hs-CRP activity in otherwise healthy smokers, the combination of which would probably contribute to a higher rate of cardiovascular events.

Keywords: C-Reactive protein/analysis, electrocardiography, heart rate/physiology, risk factors; smoking/adverse effects; sympathetic nervous system/physiology.

How to cite this article
Ömer Alyan, Fehmi Kaçmaz, Özcan Özdemir, Zülküf Karahan, Tuncay Taşkesen, Hikmet İyem, Sait Alan, Aziz Karadede, Erdoğan İlkay. High levels of high-sensitivity C-reactive protein and impaired autonomic activity in smokers. Turk Kardiyol Dern Ars. 2008; 36(6): 368-375

Corresponding Author: Ömer Alyan, Türkiye
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