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Excerpts from: Smoking Dangers

By GARRET CONDON  ctnow.com  [040801]

                One more drag of that cigarette? That one cigarette could
                trigger a heart attack - a bad one. Talk about a drag.

                Cigarettes are a well-known cause of heart disease, among
                other illnesses. Researchers have long established that
                smoking, over the long term, contributes to hardening of the
                arteries, which narrows the flow of blood to the heart muscle
                and can cause chest pain and, eventually, heart attacks.

                But a team of researchers from Hartford and Boston has
                found that cigarettes also have an immediate effect. An
                individual cigarette can actually set off a heart attack. The
                research was presented in early March at the American
                Heart Association's annual conference on cardiovascular
                disease epidemiology and prevention in San Antonio.

                "Smoking is going to give you a heart attack, not just heart
                disease,'' says Dr. Satyendra Giri, associate director of the
                Angiographic Core Laboratory at Brigham and Women's
                Hospital in Boston. Giri, the study's lead author, was a fellow
                in cardiology at Hartford Hospital in 1996, when the study
                began. It ended last year.

                The research involved 902 heart attack patients at Hartford
                Hospital, who were part of a larger study to determine the
                factors leading to the onset of a heart attack. All were given
                angiograms before the blocked artery was opened with
                balloon angioplasty or stenting. Afterward, smokers in the
                group were asked when they had smoked their last cigarette
                before getting heart attack symptoms.

                Researchers found that the closer victims were to their last
                cigarette when their symptoms began, the bigger the
                heart-attack-causing blood clot.

                The study "establishes a link between the act of smoking
                and the tendency of a blood clot to be formed and create a
                heart attack,'' says Giri. He notes that smoking is known to
                make blood platelets stickier and more likely to clot, and
                smokers are less able to dissolve clots. Smoking also
                causes an adrenaline release, which pushes up blood
                pressure and heart rate and causes blood vessels to twist
                and turn more than usual.

                All of these conditions increase the risk of a heart attack.
                And the bigger the clot, according to Giri, the greater the
                likelihood of complications in treatment.

                There is more bad news for smokers in the study. In the
                Hartford Hospital group, smokers were younger than the
                nonsmokers. The average age of smokers was about 54, vs.
                about 65 for nonsmokers. Also, smokers had fewer other
                heart attack risk factors than nonsmokers, and most
                smokers had no prior heart disease symptoms.

                "What that tells you is that people should not have a false
                sense of security,'' says Giri. Younger smokers who are
                otherwise healthy and feel fine aren't safe, he says. It might
                turn out that the first hint of heart disease will be a heart
                attack.