Tobacco Sensitiveness in Angina Pectoris and Coronary Artery Disease

Harkavy, Hebald and Silbert 1 reported the incidence of tobacco hypersensitiveness in 68 cases of thrombo-angiitis and in 122 controls. In this study it was found that 83% of thrombo-angiitis cases were hypersensitive to various tobacco extracts when tested by the intradermal method. Thirteen out of 20 patients were demonstrated by the passive transfer method to have reagins for tobacco. Only 10% of the control smokers reacted to tobacco.

The present investigation deals with results of a similar study in patients with arteriosclerosis of the coronary arteries who presented the clinical syndrome of angina pectoris, with diagnostic electrocardiographic changes. The tobacco employed in these tests was separate extracts of Burley, Maryland, Virginia, and Xanthis (Turkish tobacco), prepared according to the method of Coca. An extract consisting of a mixture of tobaccos obtained from the Allergy Department of the New York Hospital through the courtesy of Dr. Cook was also employed.

Of 36 patients with coronary artery disease, all of whom were smokers, 13 or 36% were found to give positive intradermal reactions of the urticarial type to one or another tobacco. Two cases were also tested with extracts of tobacco smoke. These tests were carried out with a saline extract (Coca) of a concentrate, prepared by Dr. Harry Sobotka from an alcoholic solution of cigarette smoke. Both patients gave positive intradermal reactions. A final conclusion, however as to the significance of smoke reactions wall have to be reserved. The average age of the 13 patients who reacted positively to tobacco extracts was 45. Four of these had a personal history of allergy. The average age of the 23 patients who did not react to tobacco wras 60 years.

The serum of 6 of the positively reacting patients was studied for the presence of specific reagins to tobacco by the passive transfer method of Prausnitz and Kustner.