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Impact of Smoking on Coronary Volume-to-Myocardial Mass Ratio: An ADVANCE Registry Substudy

Kenneth R Holmes1, Gaurav S Gulsin1, Timothy A Fairbairn1

  • 1From the Department of Radiology (K.R.H., G.S.G., J.A.L., S.L.S.) and Centre for Heart Lung Innovation & Providence Research (G.S.G., J.A.L., S.L.S.), St Paul's Hospital and University of British Columbia, 1081 Burrard St, Vancouver, BC, Canada V6Z 1Y6; Liverpool Heart and Chest Hospital, Liverpool, England (T.A.F.); Department of Radiology, Duke University School of Medicine, Durham, NC (L.H.K., M.R.P.); Wakayama Medical University, Wakayama, Japan (H.M., T. Akasaka, H.K.); Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (B.L.N., J.M.J.); Department of Cardiology, University Hospital of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Department of Regional Health Research, University of Southern Denmark, Esbjerg, Denmark (N.P.R.S.); Erasmus Medical Center, Rotterdam, the Netherlands (K.N.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.J.B.); Centro Cardiologico Monzino, Scientific Institute for Research, Hospitalization and Healthcare (IRCCS), University of Milan, Milan, Italy (G.P.); William Beaumont Hospital, Royal Oak, Mich (K.M.C.); Loyola University Medical Center, Maywood, Ill (M.G.R.); Aichi Medical University, Aichi, Japan (T. Amano); Department of Cardiology, Shin Koga Hospital, Fukuoka, Japan (T.K.); HeartFlow, Redwood City, Calif (C.R.); and University of Northern British Columbia, Prince George, British Columbia, Canada (G.W.P.).

Radiology. Cardiothoracic Imaging
|March 14, 2024
PubMed

Insights

Both current and former smoking are linked to a lower coronary volume-to-myocardial mass ratio (V/M) in patients with coronary artery disease (CAD). This finding highlights the long-term cardiac impact of smoking, even after cessation.

Area of Science:

  • Cardiology
  • Radiology
  • Public Health

Background:

  • Smoking is a major risk factor for coronary artery disease (CAD).
  • Assessing cardiac structure and function is crucial for understanding CAD progression.
  • The coronary volume-to-myocardial mass ratio (V/M) may offer insights into cardiac remodeling.

Purpose of the Study:

  • To investigate the association between smoking status and the V/M ratio in patients with CAD.
  • To identify predictors of a low V/M ratio in this population.

Main Methods:

  • Secondary analysis of data from the ADVANCE registry.
  • Inclusion of patients with suspected CAD, coronary stenosis ≥30%, and available smoking status, CT-FFR, and V/M data.
  • Calculation of V/M from coronary CT angiography (CCTA) images and comparison between smoking groups.

Main Results:

  • Current smokers showed increased myocardial mass, while former smokers had greater coronary volume compared to never-smokers.
  • Both current and former smokers exhibited a significantly lower V/M ratio than never-smokers.
  • Current smoking, former smoking, significant stenosis (≥50%), and diabetes were independent predictors of low V/M.

Conclusions:

  • Current and former smoking status are independently associated with a lower V/M ratio.
  • These findings suggest a persistent adverse effect of smoking on cardiac structure in CAD patients.
  • The V/M ratio may serve as a valuable imaging biomarker in the context of smoking and CAD.

Keywords:
CT AngiographyCardiacHeartIschemia/Infarction

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