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Published on: August 28, 2018
Association between smoking habits and severity of coronary stenosis as assessed by coronary computed tomography
Masaya Yano1, Shin-Ichiro Miura2,3, Yuhei Shiga1
1Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
Insights
Smoking significantly increases coronary artery disease (CAD) severity, including stenosis and vessel disease. Pack-years smoked, not cessation duration, strongly correlates with CAD severity, highlighting smoking
Area of Science:
- Cardiology
- Radiology
- Public Health
Background:
- Smoking is a major risk factor for arteriosclerosis and coronary artery disease (CAD).
- Limited research exists on the association between smoking habits and the severity of coronary stenosis.
- Coronary computed tomography angiography (CTA) is a key imaging modality for assessing coronary artery disease.
Purpose of the Study:
- To investigate the relationship between smoking status and the severity of coronary stenosis.
- To evaluate the impact of smoking pack-years and cessation duration on CAD metrics.
- To compare CAD prevalence and severity between smokers and non-smokers using CTA.
Main Methods:
- Retrospective analysis of 416 patients undergoing coronary CTA.
- Patients categorized into smoking (current and past) and non-smoking groups.
- Assessment of coronary artery disease (CAD) presence, number of stenosed vessels (VD), Gensini score, and coronary calcification score via CTA.
Main Results:
- Smokers exhibited significantly higher incidence of CAD, VD, Gensini score, and coronary calcification compared to non-smokers.
- Smoking pack-years showed a significant association with VD and Gensini score, particularly multi-vessel disease.
- Duration of smoking cessation in past smokers was not significantly associated with VD or Gensini score.
Conclusions:
- Smoking is strongly linked to increased coronary artery disease severity and stenosis.
- Cumulative smoking exposure (pack-years) is a critical determinant of CAD severity.
- Cessation duration does not appear to mitigate the impact of past smoking on coronary stenosis severity.
Abstract:
Smoking promotes arteriosclerosis and is one of the most important coronary risk factors. However, few studies have investigated the association between smoking habits and the severity of coronary stenosis as assessed by coronary computed tomography angiography (CTA). We enrolled 416 patients [165/251 = smoker (past and current)/non-smoker)]. They had all undergone CTA and either were clinically suspected of having coronary artery disease (CAD) or had at least one cardiovascular risk factor. We divided the patients into smoking and non-smoking groups, and evaluated the presence of CAD, the number of significantly stenosed coronary vessels (VD), and the Gensini score as assessed by CTA in the two groups. The incidence of CAD, VD, the Gensini score, and coronary calcification score in the smoking group were all significantly greater than those in the non-smoking group (CAD, p = 0.009; VD, p = 0.003; Gensini score, p = 0.007; coronary calcification score, p = 0.01). Pack-year was significantly associated with VD and the Gensini score, and was strongly associated with multi-vessel disease (2- and 3-VD) (p < 0.05), whereas the duration of cessation in past smokers was not associated with VD or the Gensini score. Pack-year, but not the duration of cessation, may be the most important factor that was associated with the severity of coronary stenosis in terms of VD and the Gensini score.
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