Giacomo Frati1,2, Roberto Carnevale3,4, Cristina Nocella3, Mariangela Peruzzi3,4, Antonino G M Marullo3, Elena De Falco3,4, Isotta Chimenti3,4, Vittoria Cammisotto3, Valentina Valenti5, Elena Cavarretta3,4, Albino Carrizzo6, Francesco Versaci5, Matteo Vitali7, Carmela Protano7, Leonardo Roever8, Arturo Giordano9, Sebastiano Sciarretta3,6, Giuseppe Biondi-Zoccai10,11. 1. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100, Latina, Italy. giacomo.frati@uniroma1.it. 2. IRCCS NEUROMED, Pozzilli, Italy. giacomo.frati@uniroma1.it. 3. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100, Latina, Italy. 4. Mediterranea Cardiocentro, Naples, Italy. 5. Division of Cardiology, Santa Maria Goretti Hospital, Latina, Italy. 6. IRCCS NEUROMED, Pozzilli, Italy. 7. Department of Public Health and Infectious Disease, Sapienza University of Rome, Rome, Italy. 8. Department of Clinical Research, Federal University of Uberlândia, Uberlândia, MG, Brazil. 9. Interventional Cardiology Unit, Pineta Grande Hospital, Castel Volturno, Italy. 10. Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Corso della Repubblica 74, 04100, Latina, Italy. giuseppe.biondizoccai@uniroma1.it. 11. Mediterranea Cardiocentro, Naples, Italy. giuseppe.biondizoccai@uniroma1.it.
Abstract
PURPOSE OF REVIEW: Modified risk products (MRP) are promoted as a safer alternative to traditional combustion cigarettes (TCC) in chronic smokers. Evidence for their lower hazardous profile is building, despite several controversies. Yet, it is unclear whether individual responses to MRP differ among consumers. We hypothesized that different clusters of subjects exist in terms of acute effects of MRP. RECENT FINDINGS: Pooling data from a total of 60 individuals, cluster analysis identified at least three clusters (labelled 1 to 3) of subjects with different electronic vaping cigarettes (EVC) effects and at least two clusters (labelled 4 to 5) of subjects with different heat-not-burn cigarettes (HNBC) effects. Specifically, oxidative stress, platelet aggregation, and endothelial dysfunction after EVC were significantly different cluster-wise (all p < 0.05), and oxidative stress and platelet aggregation after HNBC were significantly different (all p < 0.05). In particular, subjects belonging to Cluster 1 appeared to have less detrimental responses to EVC usage than subjects in Cluster 2 and 3, as shown by non-significant changes in flow-mediated dilation (FMD) and less marked increase in Nox2-derived peptide (NOX). Conversely, those assigned to Cluster 3 had the worst reaction in terms of changes in FMD, NOX, and P-selectin. Furthermore, individuals belonging to Cluster 4 responded unfavorably to both HNBC and EVC, whereas those in Cluster 5 interestingly showed less adverse results after using HNBC than EVC. Results for main analyses were consistent employing different clusters, tests, and bootstrap. Individual responses to MRP differ and smokers aiming at using EVC or HNBC as a risk reduction strategy should consider trying different MRP aiming at finding the one which is less detrimental, with subjects resembling those in Cluster 1 preferably using EVC and those resembling Cluster 5 preferably using HNBC.
PURPOSE OF REVIEW: Modified risk products (MRP) are promoted as a safer alternative to traditional combustion cigarettes (TCC) in chronic smokers. Evidence for their lower hazardous profile is building, despite several controversies. Yet, it is unclear whether individual responses to MRP differ among consumers. We hypothesized that different clusters of subjects exist in terms of acute effects of MRP. RECENT FINDINGS: Pooling data from a total of 60 individuals, cluster analysis identified at least three clusters (labelled 1 to 3) of subjects with different electronic vaping cigarettes (EVC) effects and at least two clusters (labelled 4 to 5) of subjects with different heat-not-burn cigarettes (HNBC) effects. Specifically, oxidative stress, platelet aggregation, and endothelial dysfunction after EVC were significantly different cluster-wise (all p < 0.05), and oxidative stress and platelet aggregation after HNBC were significantly different (all p < 0.05). In particular, subjects belonging to Cluster 1 appeared to have less detrimental responses to EVC usage than subjects in Cluster 2 and 3, as shown by non-significant changes in flow-mediated dilation (FMD) and less marked increase in Nox2-derived peptide (NOX). Conversely, those assigned to Cluster 3 had the worst reaction in terms of changes in FMD, NOX, and P-selectin. Furthermore, individuals belonging to Cluster 4 responded unfavorably to both HNBC and EVC, whereas those in Cluster 5 interestingly showed less adverse results after using HNBC than EVC. Results for main analyses were consistent employing different clusters, tests, and bootstrap. Individual responses to MRP differ and smokers aiming at using EVC or HNBC as a risk reduction strategy should consider trying different MRP aiming at finding the one which is less detrimental, with subjects resembling those in Cluster 1 preferably using EVC and those resembling Cluster 5 preferably using HNBC.
Authors: Emelia J Benjamin; Paul Muntner; Alvaro Alonso; Marcio S Bittencourt; Clifton W Callaway; April P Carson; Alanna M Chamberlain; Alexander R Chang; Susan Cheng; Sandeep R Das; Francesca N Delling; Luc Djousse; Mitchell S V Elkind; Jane F Ferguson; Myriam Fornage; Lori Chaffin Jordan; Sadiya S Khan; Brett M Kissela; Kristen L Knutson; Tak W Kwan; Daniel T Lackland; Tené T Lewis; Judith H Lichtman; Chris T Longenecker; Matthew Shane Loop; Pamela L Lutsey; Seth S Martin; Kunihiro Matsushita; Andrew E Moran; Michael E Mussolino; Martin O'Flaherty; Ambarish Pandey; Amanda M Perak; Wayne D Rosamond; Gregory A Roth; Uchechukwu K A Sampson; Gary M Satou; Emily B Schroeder; Svati H Shah; Nicole L Spartano; Andrew Stokes; David L Tirschwell; Connie W Tsao; Mintu P Turakhia; Lisa B VanWagner; John T Wilkins; Sally S Wong; Salim S Virani Journal: Circulation Date: 2019-03-05 Impact factor: 29.690
Authors: Dongmei Li; Isaac K Sundar; Scott McIntosh; Deborah J Ossip; Maciej Lukasz Goniewicz; Richard J O'Connor; Irfan Rahman Journal: Tob Control Date: 2019-02-13 Impact factor: 7.552
Authors: Karine Suissa; Jordan Larivière; Mark J Eisenberg; Maria Eberg; Genevieve C Gore; Roland Grad; Lawrence Joseph; Pauline M Reynier; Kristian B Filion Journal: Circ Cardiovasc Qual Outcomes Date: 2017-01
Authors: Daniel J Conklin; Suzaynn Schick; Michael J Blaha; Alex Carll; Andrew DeFilippis; Peter Ganz; Michael E Hall; Naomi Hamburg; Tim O'Toole; Lindsay Reynolds; Sanjay Srivastava; Aruni Bhatnagar Journal: Am J Physiol Heart Circ Physiol Date: 2019-02-01 Impact factor: 4.733
Authors: Steven F Babbin; Wayne F Velicer; Andrea L Paiva; Leslie Ann D Brick; Colleen A Redding Journal: Addict Behav Date: 2014-09-06 Impact factor: 3.913
Authors: Giuseppe Biondi-Zoccai; Sebastiano Sciarretta; Christopher Bullen; Cristina Nocella; Francesco Violi; Lorenzo Loffredo; Pasquale Pignatelli; Ludovica Perri; Mariangela Peruzzi; Antonino G M Marullo; Elena De Falco; Isotta Chimenti; Vittoria Cammisotto; Valentina Valenti; Flaminia Coluzzi; Elena Cavarretta; Albino Carrizzo; Francesco Prati; Roberto Carnevale; Giacomo Frati Journal: J Am Heart Assoc Date: 2019-03-19 Impact factor: 5.501
Authors: Christine D Czoli; Christine M White; Jessica L Reid; Richard J OConnor; David Hammond Journal: Tob Control Date: 2019-01-29 Impact factor: 7.552
Authors: Gerhard-Paul Diller; Aleksander Kempny; Sonya V Babu-Narayan; Marthe Henrichs; Margarita Brida; Anselm Uebing; Astrid E Lammers; Helmut Baumgartner; Wei Li; Stephen J Wort; Konstantinos Dimopoulos; Michael A Gatzoulis Journal: Eur Heart J Date: 2019-04-01 Impact factor: 29.983
Authors: Carmela Protano; Maurizio Manigrasso; Vittoria Cammalleri; Giuseppe Biondi Zoccai; Giacomo Frati; Pasquale Avino; Matteo Vitali Journal: Int J Environ Res Public Health Date: 2020-04-24 Impact factor: 3.390