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Electronic cigarette vaping with nicotine causes increased thrombogenicity and impaired microvascular function in healthy volunteers: a randomised clinical trial
Department of Clinical Sciences, Division of Cardiovascular Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Section of Medicine.
Department of Clinical Sciences, Division of Cardiovascular Medicine, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden.
Department of Medicine II, Division of Pulmonology, Medical University of Vienna, Vienna, Austria.
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2023 (English)In: Cardiovascular Toxicology, ISSN 1530-7905, E-ISSN 1559-0259, Vol. 23, no 7-8, p. 255-264Article in journal (Refereed) Published
Abstract [en]

Electronic cigarette (EC) vaping is increasingly popular, despite growing evidence of adverse health effects. To further evaluate the impact of EC use on vascular health, we investigated the effects of brief EC inhalation on flow-dependent thrombus formation and microcirculation in healthy volunteers. The study was performed with a randomised double-blind crossover design. Twenty-two healthy subjects aged between 18 and 45 years with occasional tobacco use were recruited. Subjects inhaled 30 puffs of EC aerosol with and without nicotine on two occasions separated by a wash-out period of at least 1 week. Blood samples were collected at baseline and at 15 and 60 min following exposure and analysed with the Total-Thrombus-formation analysis system evaluating fibrin-rich thrombus formation and platelet thrombus formation in whole blood under flow. Microvascular function was assessed at baseline and 30 min after exposure by laser speckle contrast imaging and iontophoresis of acetylcholine and sodium nitroprusside (SNP) to evaluate the endothelium-dependent and independent pathways of vasodilation. Compared with nicotine free EC aerosol, exposure to EC aerosol with nicotine significantly increased platelet thrombus formation and fibrin-rich thrombus formation at 15 min (p = 0.017 and p = 0.037, respectively) with normalisation after 60 min. Peak SNP-mediated microvascular perfusion, i.e. endothelium-independent vasodilation, was reduced following EC vaping with nicotine compared with baseline (p = 0.006). Thirty puffs of EC aerosol with nicotine increased platelet and fibrin-dependent thrombus formation and reduced microvascular dilatation capacity. No compelling effects of EC vaping without nicotine were observed, indicating nicotine as the main effector.

Trial registration: ClinicalTrials.gov Identifier: NCT04175457 URL: https://clinicaltrials.gov/ct2/show/NCT04175457.

Place, publisher, year, edition, pages
Springer Nature, 2023. Vol. 23, no 7-8, p. 255-264
Keywords [en]
Coagulation, E-cigarette, Electronic cigarette, Microcirculation, Nicotine, Platelets, Thrombosis
National Category
Cardiac and Cardiovascular Systems
Identifiers
URN: urn:nbn:se:umu:diva-212844DOI: 10.1007/s12012-023-09802-9PubMedID: 37548804Scopus ID: 2-s2.0-85166954236OAI: oai:DiVA.org:umu-212844DiVA, id: diva2:1787823
Funder
Swedish Heart Lung FoundationThe Swedish Heart and Lung AssociationSwedish Society of MedicineRegion StockholmRegion VästerbottenKarolinska InstituteAvailable from: 2023-08-15 Created: 2023-08-15 Last updated: 2023-10-13Bibliographically approved

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Brynedal, AmelieBlomberg, AndersBosson, Jenny A.Hedman, Linnea

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