Advs Exp. Medicine, Biology - Neuroscience and Respiration (2015) 1: 9–14 DOI 10.1007/5584_2014_5 # Springer International Publishing Switzerland 2014 Published online: 10 October 2014 Alterations in the Coagulation System of Active Smokers from the Ludwigshafen Risk and Cardiovascular Health (LURIC) Study G. Delgado, R. Siekmeier, T.B. Grammer, B.O. Boehm, W. Ma ¨rz, and M.E. Kleber Abstract Smoking is an important and preventable risk factor of cardiovascular diseases with effects on blood coagulation. Our aim was to analyze the influence of smoking on coagulation parameters. Concentrations or activities of blood coagulation factors were compared in 777 active smokers and 1,178 lifetime non-smokers of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study. The association with mortality was examined using Cox regression. The findings show that AS had a ten- dency toward thrombosis. They displayed significantly higher values for fibrinogen, soluble fibrinogen, factor XIII, and tissue factor pathway inhibitor; whereas FVII, FVIII, FXII, von Willebrand factor (vWF), and thrombomodulin were decreased. The Cox regression analysis showed fibrinogen, FVIII, vWF, thrombomodulin, and tissue factor pathway inhibitor to be independent risk factors for mortality in active smokers with hazard ratios of 1.16 (95 % CI: 1.02–1.31), 1.40 (1.22–1.59), 1.37 (1.22–1.56), 1.19 (1.07–1.31), and 1.22 (1.06–1.40) per increase of one standard deviation. We conclude that active smokers have an increased G. Delgado, T.B. Grammer, and M.E. Kleber (*) Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1, 68167 Mannheim, Germany e-mail: marcus.kleber@medma.uni-heidelberg.de R. Siekmeier Drug Regulatory Affairs, University of Bonn, Bonn, Germany B.O. Boehm Division of Endocrinology, Department of Medicine, University Hospital, Ulm, Germany LKC School of Medicine, Imperial College London and Nanyang Technological University, Singapore, Singapore W. Ma ¨rz Fifth Department of Medicine (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty of Mannheim, Heidelberg University, Theodor-Kutzer-Ufer 1, 68167 Mannheim, Germany Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University Graz, Graz, Austria Synlab Academy, Synlab Services GmbH, Mannheim, Germany 9