Association of tobacco use and cessation with coronary atherosclerosis
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Citações na Scopus
23
Tipo de produção
article
Data de publicação
2017
Editora
ELSEVIER IRELAND LTD
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Autores
CHEEZUM, Michael K.
KIM, Alexander
KASSOP, David
NISSEN, Alexander
THOMAS, Dustin M.
Binh Nguyen
GLYNN, Robert J.
SHAH, Nishant R.
VILLINES, Todd C.
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Citação
ATHEROSCLEROSIS, v.257, p.201-207, 2017
Resumo
Background and aims: The impact of tobacco use and cessation on atherogenesis remains unclear. We aimed to study the association of tobacco use and prior cessation with the presence, extent and severity of atherosclerosis on coronary computed tomographic angiography (CTA). Methods: We examined 1798 consecutive symptomatic patients without known coronary artery disease (CAD) referred for CTA, stratified by smoking status (never, current [within 30 days], or former [>30 days before CTA]). Plaque severity (none, <50%, >= 50% stenosis), composition (non-calcified [NCP], partially calcified [PCP], or calcified plaque [CP]), and segment involvement score (SIS) were visually graded. Multivariate analysis was performed, adjusting for CAD risk factors and cholesterol lowering medication use. Results: The median age of patients was 50 years [IQR: 42-58] (61% male), with 74% never smokers, 12% current smokers, and 14% former smokers (median quit duration = 12 years [IQR: 3-26]). Smoking exposure in former versus current smokers was 11 [IQR: 5-25] and 10 [IQR: 2-20] pack-years, respectively (p = 0.01). Compared to never smokers, current smokers demonstrated an increased odds ratio of all plaque types (adjusted OR: any NCP = 1.55 [95% CI 1.04-2.32], p = 0.03; any PCP = 1.61 [1.10-2.37], p = 0.02; any CP = 1.93 [1.32-2.81], p = 0.001), non-obstructive CAD (aOR = 1.47 [1.04, 2.07], p = 0.03), obstructive CAD (aOR = 1.81 [1.01-3.24], p = 0.047), and SIS > 4 (aOR = 1.60 [1.04e2.46], p = 0.03). Compared to current smoking, prior smoking cessation (>= 12 years) was associated with a decreased odds ratio of any NCP (aOR = 0.42 [0.19-0.90], p = 0.03), CP (aOR = 0.43 [0.22-0.84], p = 0.02), and obstructive CAD (aOR = 0.40, [0.15-0.98], p = 0.048). Conclusions: Current smoking is independently associated with the presence and extent of coronary plaque, and a higher risk of non-obstructive and obstructive CAD compared to never smoking. Prior smoking cessation correlated with improvements in CTA-identified plaque measures.
Palavras-chave
Atherosclerosis, Coronary computed tomographic angiography, Smoking, Tobacco, Coronary artery disease
Referências
- Abbara Suhny, 2009, J Cardiovasc Comput Tomogr, V3, P190, DOI 10.1016/j.jcct.2009.03.004
- AGATSTON AS, 1990, J AM COLL CARDIOL, V15, P827
- Ambrose JA, 2004, J AM COLL CARDIOL, V43, P1731, DOI 10.1016/j.jacc.2003.12.047
- Bittencourt MS, 2014, CIRC-CARDIOVASC IMAG, V7, P282, DOI 10.1161/CIRCIMAGING.113.001047
- Chamberlain JJ, 2016, ANN INTERN MED, V164, P542, DOI 10.7326/M15-3016
- Cheezum MK, 2015, EUR HEART J-CARD IMG, V16, P1338, DOI 10.1093/ehjci/jev087
- Cheezum MK, 2013, JACC-CARDIOVASC IMAG, V6, P574, DOI 10.1016/j.jcmg.2012.11.016
- Ford ES, 2007, NEW ENGL J MED, V356, P2388, DOI 10.1056/NEJMsa053935
- Halliburton SS, 2011, J CARDIOVASC COMPUT, V5, P198, DOI 10.1016/j.jcct.2011.06.001
- Hulten EA, 2011, J AM COLL CARDIOL, V57, P1237, DOI 10.1016/j.jacc.2010.10.011
- Inoue Teruo, 2004, Tob Induc Dis, V2, P27, DOI 10.1186/1617-9625-2-1-27
- Jamal A, 2014, MMWR-MORBID MORTAL W, V63, P1108
- James PA, 2014, JAMA-J AM MED ASSOC, V5, P507
- Jefferis BJ, 2010, ATHEROSCLEROSIS, V208, P550, DOI 10.1016/j.atherosclerosis.2009.07.044
- Kallio K, 2010, CIRC-CARDIOVASC QUAL, V3, P196, DOI 10.1161/CIRCOUTCOMES.109.857771
- Kim Jin, 2013, [Journal of the Korean Society of Cadastre, 한국지적학회지], V29, P1
- Le J, 2010, CIRC-CARDIOVASC IMAG, V3, P8, DOI 10.1161/CIRCIMAGING.109.880070
- Leipsic J, 2014, J CARDIOVASC COMPUT, V8, P342, DOI 10.1016/j.jcct.2014.07.003
- McEvoy J. W., 2015, VASC BIOL, V35, P1002
- Min JK, 2007, J AM COLL CARDIOL, V50, P1161, DOI 10.1016/j.jacc.2007.03.067
- Mobarrez F, 2014, PLOS ONE, V9, DOI 10.1371/journal.pone.0090314
- Nakanishi R, 2015, EUR HEART J, V36, P1031, DOI 10.1093/eurheartj/ehv013
- Novak J, 2015, ADV EXP MED BIOL, V887, P79, DOI 10.1007/978-3-319-22380-3_5
- Samanta S, 2016, TRENDS CARDIOVAS MED, V26, P407, DOI 10.1016/j.tcm.2016.02.004
- Shah Reena S, 2010, Expert Rev Cardiovasc Ther, V8, P917, DOI 10.1586/erc.10.56
- [Anonymous], 2007, IARC HDB CANC PREV, V11, P11
- US Department of Health and Human Services, 2014, HLTH CONSMOK 50 YE
- van Domburg RT, 2000, J AM COLL CARDIOL, V36, P878, DOI 10.1016/S0735-1097(00)00810-X
- Wronska A, 2015, ACTA PHYSIOL, V213, P60, DOI 10.1111/apha.12416
- [Anonymous], 2002, CIRCULATION, V106, P3143