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Changes in carotid artery structure with smoking cessation.

Carol Mitchell1, Megan E Piper2, Stevens S Smith2

  • 1Department of Medicine, Cardiovascular Medicine Division, University of Wisconsin Atherosclerosis Imaging Research Program, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.

Vascular Medicine (London, England)
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Summary

Smoking cessation shows modest changes in carotid artery ultrasound measures, primarily linked to weight gain. These findings suggest that while quitting smoking may not immediately alter these specific markers, weight management is a key factor.

Keywords:
carotid ultrasoundgrayscalegrayscale median (GSM)smokingvascular imaging

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Area of Science:

  • Cardiovascular Imaging
  • Vascular Ultrasound
  • Smoking Cessation Research

Background:

  • Carotid artery ultrasound echogenicity and texture features are established predictors of cardiovascular disease events.
  • The longitudinal impact of smoking cessation on these specific ultrasound markers remains incompletely understood.
  • Understanding these changes is crucial for assessing the vascular benefits of quitting smoking.

Purpose of the Study:

  • To evaluate the longitudinal effects of smoking cessation on four grayscale ultrasound measures of the carotid artery.
  • To determine if changes in carotid artery ultrasound markers during smoking cessation are independent of weight gain.

Main Methods:

  • Secondary analysis of 188 age, sex, and BMI-matched smokers (94 eventual abstainers, 94 continued smokers) from a smoking cessation trial.
  • Carotid ultrasound examinations were performed at baseline and after 3 years.
  • General linear models analyzed the impact of time, smoking group, and their interaction on carotid artery grayscale marker values.

Main Results:

  • A significant time*smoking status interaction predicted Grayscale Median (GSM) at year 3, with GSM decreasing in abstainers compared to continued smokers (p=0.029).
  • Body Mass Index (BMI) increased significantly more in the eventual abstainers than in continued smokers (p<0.001).
  • After adjusting for BMI changes, the significant interaction between time and smoking status for GSM was no longer observed (p=0.138).

Conclusions:

  • Changes in carotid artery ultrasound echogenicity and grayscale texture features during smoking cessation attempts are modest.
  • These observed changes are predominantly associated with concurrent weight gain.
  • Further research should consider the interplay between weight management and vascular adaptations post-smoking cessation.