Evaluation of Plasma Fibrinogen Level, Platelet Count & Lipid Profile as Predictors of Cardiovascular Disease among Bangladeshi Healthy Male Smokers

Background: Smoking represents a substantial global health challenge, correlating with heightened rates of mortality and morbidity, notably including the onset of cancer. Within tobacco smoke are carcinogenic substances capable of perturbing cellular mechanisms and immune responses, thereby potentially influencing coagulation metrics and lipid profiles.

Objective: This study aimed to investigate the plasma fibrinogen level, platelet count & lipid profile as predictors of cardiovascular disease among Bangladeshi healthy male smokers.

Methods: A cross-sectional analytical study was conducted at the Department of Physiology, Sir Salimullah Medical College (SSMC) in Dhaka, Bangladesh, from July 1, 2018, to June 30, 2019. Seventy male participants aged 20 to 40 years were enrolled, comprising 35 healthy non-smokers (Group A) and 35 male smokers (Group B). Smokers were further categorized into two groups based on pack year (5-15 pack year for B1 & >15 pack year for B2). Coagulation parameters including plasma fibrinogen and platelet count and lipid profile were assessed.

Results: The study comprised 70 subjects, evenly divided into Group A and Group B, with comparable mean ages of 33.17 ± 2.91 years and 34.11 ± 3.18 years, respectively, and similar mean body mass index (BMI) values of 24.36 ± 2.28 kg/m2 and 24.68 ± 2.33 kg/m2. Plasma fibrinogen levels were significantly higher in Group B (315.55 ± 67.79 mg/dL) compared to Group A (222.49 ± 23.03 mg/dL), as were platelet counts (285.14 ± 34.33 x109/L in Group B vs. 235.20 ± 46.83 x109/L in Group A). Further stratification of Group B revealed higher fibrinogen levels in both subgroups, B1 and B2, compared to Group A, with B2 exhibiting the highest fibrinogen levels. Platelet counts followed a similar trend, with both B1 and B2 having significantly higher counts than Group A. Plasma fibrinogen level was positively correlated with pack-years of smoking, while platelet counts showed a positive but statistically non-significant correlation. Smokers exhibited elevated total cholesterol (TC), triglycerides (TG), and low-density lipoprotein (LDL) levels, along with decreased high-density lipoprotein (HDL) levels compared to non-smokers. Moreover, there was a significant positive correlation between pack-years of smoking and TC, TG, and LDL levels, while HDL levels exhibited a significant negative correlation. These findings underscore the complex interplay between smoking, coagulation parameters, and lipid profiles, emphasizing the multifaceted impact of smoking on cardiovascular health.

Conclusion: In conclusion, the study highlights the intricate relationship between smoking, coagulation parameters, and lipid profiles in a cohort of 70 subjects. Smokers exhibited elevated plasma fibrinogen levels and platelet counts compared to non-smokers, with a significant positive correlation observed between pack-years of smoking and these coagulation parameters. Additionally, smokers demonstrated higher levels of total cholesterol, triglycerides, and low-density lipoprotein, alongside lower levels of high-density lipoprotein, indicative of dyslipidemic state in the direction of increased risk for coronary artery disease. Furthermore, the discovered alterations in plasma fibrinogen, platelet, and lipid profiles serve as early predictors of cardiovascular disease, advocating for proactive management strategies in individuals with a smoking history.