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Impact of chronic use of heat-not-burn cigarettes on oxidative stress, endothelial dysfunction and platelet activation: the SUR-VAPES Chronic Study
  1. Lorenzo Loffredo1,
  2. Roberto Carnevale2,3,
  3. Simona Battaglia1,
  4. Roberta Marti4,
  5. Stefano Pizzolo4,
  6. Simona Bartimoccia5,
  7. Cristina Nocella1,
  8. Vittoria Cammisotto6,
  9. Sebastiano Sciarretta7,8,
  10. Isotta Chimenti3,9,
  11. Elena De Falco3,9,
  12. Elena Cavarretta3,9,
  13. Mariangela Peruzzi3,9,
  14. Antonino Marullo9,
  15. Fabio Miraldi4,
  16. Francesco Violi1,3,
  17. Andrea Morelli4,
  18. Giuseppe Biondi-Zoccai3,9,
  19. Giacomo Frati8,9
  1. 1 Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Roma, Lazio, Italy
  2. 2 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Sapienza University of Rome, Roma, Italy
  3. 3 Mediterranea Cardiocentro, Napoli, Italy
  4. 4 Sapienza University of Rome, Roma, Lazio, Italy
  5. 5 Department of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Sapienza University of Rome, Roma, Lazio, Italy
  6. 6 Department of General Surgery and Surgical Speciality Paride Stefanini, Sapienza University of Rome, Roma, Lazio, Italy
  7. 7 Universita degli Studi di Roma La Sapienza, Roma, Italy
  8. 8 IRCCS NeuroMed, Pozzilli, Italy
  9. 9 Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Roma, Lazio, Italy
  1. Correspondence to Professor Lorenzo Loffredo, Department of Clinical Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Roma 00161, Italy; lorenzo.loffredo{at}uniroma1.it; Dr Roberto Carnevale, Department of Medical-Surgical Sciences and Biotechnologies, Sapienza University of Rome, 00185 Roma, Italy; roberto.carnevale{at}uniroma1.it

Abstract

Tobacco habit still represents the leading preventable cause of morbidity and mortality worldwide. Heat-not-burn cigarettes (HNBCs) are considered as an alternative to traditional combustion cigarettes (TCCs) due to the lack of combustion and the absence of combustion-related specific toxicants. The aim of this observational study was to assess the effect of HNBC on endothelial function, oxidative stress and platelet activation in chronic adult TCC smokers and HNBC users. The results showed that both HNBC and TCC display an adverse phenotype in terms of endothelial function, oxidative stress and platelet activation. Future randomised studies are strongly warranted to confirm these data.

  • oxidative stress
  • tobacco control
  • heated tobacco product

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Footnotes

  • GB-Z and GF are co-senior authors.

  • LL and RC contributed equally.

  • Contributors LL and RC: full access to all of the data in the study, takes responsibility for the integrity of the data and the accuracy of the data analysis, and wrote the manuscript; SBat, RM and SP: patient recruitment; SBar, CN and VC experimental work, writing the manuscript; SS, IC, EDF, EC, MP, AM, FM, FV and AM: data analysis and interpretation, writing the manuscript, review and editing; GB-Z: formal analysis; GF: conceptualisation, supervision, writing the manuscript, review and editing.

  • Funding This study was supported by Sapienza University of Rome (grant 2018 Prot. RM118164264ED867), 'The Sapienza University of Rome-Vascular Assessment of Proatherosclerotic Effects of Smoking (SUR-VAPES) 4 trial' to GF and by Sapienza University of Rome (grant 2020 Prot. RM120172B3C38D48), 'Impact of chronic use of heat-not-burn cigarettes on oxidative stress, endhotelial dysfunction and platelet activation in adults and children' to LL.

  • Competing interests GB-Z has consulted for Cardionovum, InnovHeart, Meditrial and Replycare. All remaining authors declare no conflict of interest or financial disclosures.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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