234 Early improvement in peripheral vascular tone following smoking cessation using nicotine replacement therapy: aortic wave reflection analysis

ObjectivesCigarette smoking induces cardiovascular pathology and worsens arterial stiffness. Arterial stiffness can be assessed non-invasively on 2 indices: pulse-wave velocity (PWV), indicating aortic stiffness, and augmentation index (AIx), indicating aortic wave reflection. The impact of smoking cessation (SC) nicotine replacement therapies (NRT) on arterial stiffness remains unknown.MethodsAIx and PWV were studied prospectively (SphygmoCor) in 26 long-term smokers (>10 cigarettes/day; mean age, 43 ± 6 yrs) before (V1) and 28 and 56 days (V2, V3) after SC supported by NRT. Two-way repeated-measures ANOVA was used with patients serving their own controls on intention-to-treat analysis. Abstinence was ascertained when exhaled carbon monoxide (CO) was <10ppm; the quantity of NRT absorbed was assessed from the serum cotinine level.Results16/24 patients (67%) were abstinent at end of study; 8/24 had cut down on smoking; 2 were lost to follow-up. CO and serum cotinine levels fell after SC. Mean AIx for the population as a whole was 23.4% at V1, with significant early reduction by V2 (16.2%) and V3 (13.9%) (ANOVA p