Current but not past smoking increases the risk of cardiac events: insights from coronary computed tomographic angiography

dc.contributor.authorNakanishi, Rine
dc.contributor.authorBerman, Daniel S.
dc.contributor.authorBudoff, Matthew J.
dc.contributor.authorGransar, Heidi
dc.contributor.authorAchenbach, Stephan
dc.contributor.authorAl-Mallah, Mouaz
dc.contributor.authorAndreini, Daniele
dc.contributor.authorCademartiri, Filippo
dc.contributor.authorCallister, Tracy Q.
dc.contributor.authorChang, Hyuk-Jae
dc.contributor.authorCheng, Victor Y.
dc.contributor.authorChinnaiyan, Kavitha
dc.contributor.authorChow, Benjamin J.W.
dc.contributor.authorCury, Ricardo
dc.contributor.authorDelago, Augustin
dc.contributor.authorHadamitzky, Martin
dc.contributor.authorHausleiter, Jörg
dc.contributor.authorFeuchtner, Gudrun
dc.contributor.authorKim, Yong-Jin
dc.contributor.authorKaufmann, Philipp A.
dc.contributor.authorLeipsic, Jonathon
dc.contributor.authorLin, Fay Y.
dc.contributor.authorMaffei, Erica
dc.contributor.authorPontone, Gianluca
dc.contributor.authorRaff, Gilbert
dc.contributor.authorShaw, Leslee J.
dc.contributor.authorVillines, Todd C.
dc.contributor.authorDunning, Allison
dc.contributor.authorMin, James K.
dc.description.abstractAims: We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). Methods and results: We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588 current smokers; 2183 past smokers who quit ≥3 months before CCTA; and 5685 never smokers). By risk-adjusted Cox proportional-hazards models, we related smoking status to MACE (all-cause death or non-fatal myocardial infarction). We further performed 1:1:1 propensity matching for 1000 in each group evaluate event risk among individuals with similar age, gender, CAD risk factors, and symptom presentation. During a mean follow-up of 2.8 ± 1.9 years, 297 MACE occurred. Compared with never smokers, current and past smokers had greater atherosclerotic burden including extent of plaque defined as segments with any plaque (2.1 ± 2.8 vs. 2.6 ± 3.2 vs. 3.1 ± 3.3, P < 0.0001) and prevalence of obstructive CAD [1-vessel disease (VD): 10.6% vs. 14.9% vs. 15.2%, P < 0.001; 2-VD: 4.4% vs. 6.1% vs. 6.2%, P = 0.001; 3-VD: 3.1% vs. 5.2% vs. 4.3%, P < 0.001]. Compared with never smokers, current smokers experienced higher MACE risk [hazard ratio (HR) 1.9, 95% confidence interval (CI) 1.4–2.6, P < 0.001], while past smokers did not (HR 1.2, 95% CI 0.8–1.6, P = 0.35). Among matched individuals, current smokers had higher MACE risk (HR 2.6, 95% CI 1.6–4.2, P < 0.001), while past smokers did not (HR 1.3, 95% CI 0.7–2.4, P = 0.39). Similar findings were observed for risk of all-cause death. Conclusion: Among patients without known CAD undergoing CCTA, current and past smokers had increased burden of atherosclerosis compared with never smokers; however, risk of MACE was heightened only in current smokers.en
dc.format.extent1031 - 1040
dc.identifier.citationEuropean Heart Journal 36.17 (2015): S. 1031-1040. <>
dc.subjectSmoking risk
dc.subjectCoronary atherosclerosis
dc.subjectCoronary computed tomographic angiography
dc.subjectMajor adverse cardiovascular risk
dc.subject.ddcDDC Classification::6 Technik, Medizin, angewandte Wissenschaften :: 61 Medizin und Gesundheit :: 610 Medizin und Gesundheit
dc.titleCurrent but not past smoking increases the risk of cardiac events: insights from coronary computed tomographic angiographyen
dcterms.publisherFriedrich-Alexander-Universität Erlangen-Nürnberg (FAU)
local.journal.titleEuropean Heart Journal
local.subject.fakultaetMedizinische Fakultät
local.subject.sammlungUniversität Erlangen-Nürnberg / Allianzlizenzen: Alle Beiträge sind mit Zustimmung der Rechteinhaber aufgrund einer DFG-geförderten Allianzlizenz frei zugänglich. / Allianzlizenzen 2015
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