Association between smoking status and subclinical coronary atherosclerosis in asymptomatic Korean individuals
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OBJECTIVES: In this study, we sought to evaluate the association between smoking status and subclinical coronary atherosclerosis, as detected by coronary computed tomography angiography (CCTA), in asymptomatic individuals.METHODS: We retrospectively analyzed 9,285 asymptomatic participants (mean age, 53.7±8.0 years; n=6,017, 64.8% male) with no history of coronary artery disease (CAD) who had undergone self-referred CCTA. Of these participants, 4,333 (46.7%) were considered never smokers, 2,885 (31.1%) former smokers, and 2,067 (22.3%) current smokers. We assessed the degree and characteristics of subclinical coronary atherosclerosis using CCTA, with obstructive CAD defined as a diameter stenosis of at least 50%.RESULTS: Compared with never-smokers, former smokers exhibited no significant differences in the probabilities of obstructive CAD, any coronary plaque, calcified plaque, or mixed plaque, as determined using adjusted odds ratios (aORs; p>0.05 for all). However, the risk of non-calcified plaque was significantly higher in former smokers (aOR, 1.34; 95% confidence interval [CI], 1.00 to 1.78; p=0.048). Current smokers had significantly higher rates of obstructive CAD (aOR, 1.46; 95% CI, 1.10 to 1.96; p=0.010), any coronary plaque (aOR, 1.41; 95% CI, 1.20 to 1.65; p<0.001), calcified plaque (aOR, 1.32; 95% CI, 1.13 to 1.55; p=0.001), non-calcified plaque (aOR, 1.72; 95% CI, 1.28 to 2.32; p<0.001), and mixed plaque (aOR, 2.00; 95% CI, 1.39 to 2.86; p<0.001) compared to never smokers.CONCLUSIONS: This cross-sectional study revealed a significant association between current smoking and subclinical coronary atherosclerosis, as detected on CCTA. Additionally, former smoking demonstrated an association with non-calcified plaque, indicating elevated cardiovascular risk.
Abstract
OBJECTIVES: In this study, we sought to evaluate the association between smoking status and subclinical coronary atherosclerosis, as detected by coronary computed tomography angiography (CCTA), in asymptomatic individuals.METHODS: We retrospectively analyzed 9,285 asymptomatic participants (mean age, 53.7±8.0 years; n=6,017, 64.8% male) with no history of coronary artery disease (CAD) who had undergone self-referred CCTA. Of these participants, 4,333 (46.7%) were considered never smokers, 2,885 (31.1%) former smokers, and 2,067 (22.3%) current smokers. We assessed the degree and characteristics of subclinical coronary atherosclerosis using CCTA, with obstructive CAD defined as a diameter stenosis of at least 50%.RESULTS: Compared with never-smokers, former smokers exhibited no significant differences in the probabilities of obstructive CAD, any coronary plaque, calcified plaque, or mixed plaque, as determined using adjusted odds ratios (aORs; p>0.05 for all). However, the risk of non-calcified plaque was significantly higher in former smokers (aOR, 1.34; 95% confidence interval [CI], 1.00 to 1.78; p=0.048). Current smokers had significantly higher rates of obstructive CAD (aOR, 1.46; 95% CI, 1.10 to 1.96; p=0.010), any coronary plaque (aOR, 1.41; 95% CI, 1.20 to 1.65; p<0.001), calcified plaque (aOR, 1.32; 95% CI, 1.13 to 1.55; p=0.001), non-calcified plaque (aOR, 1.72; 95% CI, 1.28 to 2.32; p<0.001), and mixed plaque (aOR, 2.00; 95% CI, 1.39 to 2.86; p<0.001) compared to never smokers.CONCLUSIONS: This cross-sectional study revealed a significant association between current smoking and subclinical coronary atherosclerosis, as detected on CCTA. Additionally, former smoking demonstrated an association with non-calcified plaque, indicating elevated cardiovascular risk.
참고문헌 (36)
- GBD 2019 Diseases and Injuries Collaborators, "Global burden of 369 diseases and injuries in 204 countries and territories, 1990-2019 : a systematic analysis for the Global Burden of Disease Study 2019", Lancet, 396, pp.1204~1222 (2020)[DOI]
- Wilson PW, "Prediction of coronary heart disease using risk factor categories", Circulation, 97, pp.1837~1847 (1998)[DOI]
- Goff DC Jr, "2013 ACC", AHA guideline on the assessment of cardiovascular risk : a report of the American College of Cardiology, J Am Coll Cardiol, pp.2014, 63[DOI]
- Conroy RM, "Estimation of ten-year risk of fatal cardiovascular disease in Europe : the SCORE project", Eur Heart J, 24, pp.987~1003 (2003)[DOI]
- Hisamatsu T, "Smoking, smoking cessation, and measures of subclinical atherosclerosis in multiple vascular beds in Japanese men", J Am Heart Assoc, 5, pp.e003738~ (2016)[DOI]
- Park GM, "Prevalence of coronary atherosclerosis in an Asian population : findings from coronary computed tomographic angiography", Int J Cardiovasc Imaging, 31, pp.659~668 (2015)[DOI]
- Nakanishi R, "Current but not past smoking increases the risk of cardiac events : insights from coronary computed tomographic angiography", Eur Heart J, 36, pp.1031~1040 (2015)[DOI]
- Yi M, "Coronary CT angiography findings based on smoking status: do ex-smokers and never-smokers share a low probability of developing coronary atherosclerosis?", Int J Cardiovasc Imaging, 31(Suppl 2), pp.169~176 (2015)[DOI]
- Ann SH, "Marital status and subclinical coronary atherosclerosis in asymptomatic individuals", J Am Heart Assoc, 11, pp.e024942~ (2022)[DOI]
- Lee H, "Lipoprotein(a)and subclinical coronary atherosclerosis in asymptomatic individuals", Atherosclerosis, 349, pp.190~195 (2022)[DOI]
- Park S, "Self-rated subjective health status is strongly associated with sociodemographic factors, lifestyle, nutrient intakes, and biochemical indices, but not smoking status : KNHANES 2007-2012", J Korean Med Sci, 30, pp.1279~1287 (2015)[DOI]
- Park GM, "Model for assessing cardiovascular risk in a Korean population", Circ Cardiovasc Qual Outcomes, 7, pp.944~951 (2014)[DOI]
- Agatston AS, "Quantification of coronary artery calcium using ultrafast computed tomography", J Am Coll Cardiol, 15, pp.827~832 (1990)[DOI]
- Leber AW, "Accuracy of 64-slice computed tomography to classify and quantify plaque volumes in the proximal coronary system : a comparative study using intravascular ultrasound", J Am Coll Cardiol, 47, pp.672~677 (2006)[DOI]
- Loria CM, "Early adult risk factor levels and subsequent coronary artery calcification : the CARDIA Study", J Am Coll Cardiol, 49, pp.2013~2020 (2007)[DOI]
- Jöckel KH, "Smoking cessation and subclinical atherosclerosis--results from the Heinz Nixdorf Recall Study", Atherosclerosis, 203, pp.221~227 (2009)[DOI]
- Howard G, "Cigarette smoking and progression of atherosclerosis : the Atherosclerosis Risk in Communities(ARIC)Study", JAMA, 279, pp.119~124 (1998)[DOI]
- Shaw LJ, "Prognostic value of coronary artery calcium screening in asymptomatic smokers and non-smokers", Eur Heart J, 27, pp.968~975 (2006)[DOI]
- Min JK, "Determinants of coronary calcium conversion among patients with a normal coronary calcium scan : what is the"warranty period"for remaining normal?", J Am Coll Cardiol, 55, pp.1110~1117 (2010)[DOI]
- Kianoush S, "Associations of cigarette smoking with subclinical inflammation and atherosclerosis : ELSA-Brasil(The Brazilian Longitudinal Study of Adult Health)", J Am Heart Assoc, 6, pp.e005088~ (2017)[DOI]
- Gordon T, "Death and coronary attacks in men after giving up cigarette smoking. A report from the Framingham study", Lancet, 2, pp.1345~1348 (1974)[DOI]
- Virmani R, "Lessons from sudden coronary death : a comprehensive morphological classification scheme for atherosclerotic lesions", Arterioscler Thromb Vasc Biol, 20, pp.1262~1275 (2000)[DOI]
- Lee S, "Subclinical coronary artery disease as detected by coronary computed tomography angiography in an asymptomatic population", Korean Circ J, 40, pp.434~441 (2010)[DOI]
- Villines TC, "Prevalence and severity of coronary artery disease and adverse events among symptomatic patients with coronary artery calcification scores of zero undergoing coronary computed tomography angiography : results from the CONFIRM(Coronary CT Angiography Evaluation for Clinical Outcomes : An International Multicenter)registry", J Am Coll Cardiol, 58, pp.2533~2540 (2011)[DOI]
- Kral BG, "Noncalcified coronary plaque volumes in healthy people with a family history of early onset coronary artery disease", Circ Cardiovasc Imaging, 7, pp.446~453 (2014)[DOI]
- Motoyama S, "Computed tomographic angiography characteristics of atherosclerotic plaques subsequently resulting in acute coronary syndrome", J Am Coll Cardiol, 54, pp.49~57 (2009)[DOI]
- Lee MS, "Asymptomatic subjects with zero coronary calcium score : coronary CT angiographic features of plaques in event-prone patients", Int J Cardiovasc Imaging, 29(Suppl 1), pp.29~36 (2013)[DOI]
- Meijs MF, "Comparison of frequency of calcified versus non-calcified coronary lesions by computed tomographic angiography in patients with stable versus unstable angina pectoris", Am J Cardiol, 104, pp.305~311 (2009)[DOI]
- Thomsen C, "Characteristics of high-risk coronary plaques identified by computed tomographic angiography and associated prognosis : a systematic review and meta-analysis", Eur Heart J Cardiovasc Imaging, 17, pp.120~129 (2016)[DOI]
- Rosenberg L, "The risk of myocardial infarction after quitting smoking in men under 55 years of age", N Engl J Med, 313, pp.1511~1514 (1985)[DOI]
- Messner B, "Smoking and cardiovascular disease : mechanisms of endothelial dysfunction and early atherogenesis", Arterioscler Thromb Vasc Biol, 34, pp.509~515 (2014)[DOI]
- Park HW, "Cholesterol control for subclinical coronary atherosclerosis in subjects without indication for statin therapy", Am J Cardiol, 153, pp.51~57 (2021)[DOI]
- Kang SH, "Long-term prognostic value of coronary CT angiography in asymptomatic type 2 diabetes mellitus", JACC Cardiovasc Imaging, 9, pp.1292~1300 (2016)[DOI]
- McEvoy JW, "Relationship of cigarette smoking with inflammation and subclinical vascular disease : the Multi-Ethnic Study of Atherosclerosis", Arterioscler Thromb Vasc Biol, 35, pp.1002~1010 (2015)[DOI]
- Rosenberg L, "Decline in the risk of myocardial infarction among women who stop smoking", N Engl J Med, 322, pp.213~217 (1990)[DOI]
- Ding N, "Cigarette smoking, smoking cessation, and long-term risk of 3 major atherosclerotic diseases", J Am Coll Cardiol, 74, pp.498~507 (2019)[DOI]
