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[Progression of coronary sclerosis after smoking cessation]
1Abteilung Kardiologie, Medizinische Hochschule Hannover.
Insights
Heavy smoking significantly increases coronary artery disease progression, even years after quitting. Cessation is advised, as past heavy smoking remains a risk factor for coronary artery disease progression.
Area of Science:
- Cardiology
- Public Health
Background:
- Cigarette smoking is a known risk factor for coronary artery disease (CAD).
- The impact of heavy smoking cessation on CAD progression remains unclear.
Purpose of the Study:
- To investigate whether cessation of heavy smoking influences the progression of coronary artery disease.
Main Methods:
- Two coronary angiograms were performed on 390 patients with CAD at approximately 62-month intervals.
- Smoking habits were assessed via questionnaires.
- CAD progression was quantified by new stenoses, progression of existing stenoses, and new occlusions.
Main Results:
- Cigarette smoking (amount and duration) was the most significant factor for CAD progression.
- Former heavy smokers who quit ~10 years prior showed significantly higher progression (2.20) than non-smokers (0.96).
- Current smokers exhibited the highest progression score (3.17).
Conclusions:
- Former heavy cigarette smoking is a persistent risk factor for CAD progression, even after cessation.
- Quitting smoking at the time of diagnosis (progression 2.47) still showed significant CAD progression.
- These findings underscore the long-term detrimental effects of heavy smoking on cardiovascular health.
Abstract:
Cigarette smoking is an established risk factor for the development of coronary artery disease, but whether cessation of heavy smoking influences progression of coronary artery disease is unclear. In 390 patients (359 men, 31 women; 52.4 +/- 6.7 SD years) with coronary artery disease, two coronary angiograms were performed at an interval of 62.4 +/- 23.5 months. Smoking habits were obtained by questionnaires. Progression of coronary artery disease was defined as the sum of new stenoses, progression of existing stenoses and new coronary occlusions. Multivariate classification analyses of risk factor profile revealed cigarette smoking (amount per day and length of time) as the most relevant factor for progression of coronary artery disease. Non-smokers had a progression score of 0.96 (95% confidence interval: 0.63-1.28) over the observation period. Former smokers (20.2 +/- 11.8 cigarettes/day for 19.4 +/- 7.6 years) who quit about 10 years before the first angiogram showed a progression of 2.20 (95% confidence interval: 1.77-2.63; p < 0.01) compared to non-smokers. Those smokers (23.8 +/- 9.2 cigarettes/day for 31.3 +/- 7.0 years) who quit at the time of the first angiogram showed a progression of 2.47 (95% confidence interval: 1.97-2.97; p < 0.001). Current smokers (20.5 +/- 9.7 cigarettes/day for 34.8 +/- 8.5 years) had a progression of 3.17 (95% confidence interval: 2.35-3.99; p < 0.001). The data indicate that former heavy cigarette smoking continues to act as a significant risk factor for progression of coronary artery disease even after cessation. This does not mean that current cigarette smokers should not stop.(ABSTRACT TRUNCATED AT 250 WORDS)