E-cigarettes with nicotine may affect thrombotic activity, impair microcirculation

Use of e-cigarettes that contain nicotine may cause an immediate increase in blood clot formation and deterioration of the expansion and dilation of small blood vessels, researchers reported.

“Nicotine is indicated as the main culprit causing increased thrombogenicity following electronic cigarette use,” Gustaf Lyytinen, MD, resident clinician in the department of internal medicine at Helsingborg Hospital and doctoral student at the Karolinska Institutet Danderyd Hospital in Stockholm, said during a presentation at the virtual European Respiratory Society International Congress. “We can hypothesize this is due to catecholamine release and activation of the sympathetic nervous system or by increased pulse and blood pressure seen in our studies as well.”

Lyytinen and colleagues conducted a double-blind, randomized, crossover study that included 22 healthy adults who reported occasional tobacco use. Each participant was tested before and after inhalation of 30 puffs of an e-cigarette containing nicotine and then before and after inhalation of 30 puffs without nicotine. These tests occurred separately with a washout period of 1 week.

Researchers obtained blood samples at baseline and 15 and 60 minutes after inhalation. Microcirculation was evaluated at baseline and 30 minutes after inhalation using laser speckle contrast imaging and iontophoresis of acetylcholine and sodium-nitroprusside to assess endothelium-dependent and independent pathways.

The researchers reported a significant increase in platelet thrombus formation (P = .011) and fibrin-rich thrombus formation (P = .035) 15 minutes after participants used e-cigarettes with nicotine. These effects disappeared and returned to baseline levels 60 minutes after exposure, according to the results. There was no effect on platelet formation with vaping e-cigarettes without nicotine, Lyytinen said.

Researchers observed a significant decrease in peak endothelial independent microvascular flux when vaping e-cigarettes with nicotine compared with baseline (P = .009). However, there were no effects observed in the endothelial-dependent microvascular flux between e-cigarettes with or without nicotine.

In addition, there was no significant difference in microvascular function between vaping e-cigarettes with or without nicotine.

These findings add to current evidence base on the harmful impact of e-cigarettes and support recommendations from the European Respiratory Society for smokers to use other aids for smoking cessation, such as patches or gum, that do not risk exposing the lungs to potentially toxic compounds, according to an ERS press release.

“We can conclude that electronic cigarettes’ vapor containing nicotine has an immediate impact on thrombus formation, mainly platelet thrombus formation and also on the vascular function with increased pulse and blood pressure following use,” Lyytinen said. “Further, inhaled nicotine may impact vascular health when used on a regular basis.”

Reference:

• E-cigarettes containing nicotine cause blood clotting and make small blood vessels less adaptable. https://www.ersnet.org/news-and-features/news/e-cigarettes-nicotine-blood-clotting-blood-vessels/. Published Sept. 6, 2021. Accessed Sept. 27, 2021.