Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital, Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do 463-707, Korea.
Int J Cardiovasc Imaging. 2013 Jun;29 Suppl 1:21-8. doi: 10.1007/s10554-013-0224-8. Epub 2013 Apr 27.
Current smoking is a powerful independent predictor of coronary atherosclerosis in asymptomatic individuals. Many researchers have suggested a cigarette dose-response relationship between smoking and subclinical coronary atherosclerosis. Our study purposes were (a) to investigate the prevalence and plaque characteristics of coronary atherosclerosis in asymptomatic smokers and (b) to assess the cigarette dose-response relationship between smoking and subclinical coronary atherosclerosis using coronary CT angiography (CTA). We consecutively enrolled 7,104 self-referred asymptomatic subjects who underwent coronary CTA as part of a general health evaluation. Current smokers (n = 1,784) were categorized according to total pack years (TPY) with four grades (A, 0.1-10; B, 10-20; C, 20-30; D, >30), smoking duration (SD, years) with four grades (A, 0.1-10; B, 10-20; C, 20-30; D, >30), and number of cigarettes per day (CPD) with four grades (A, 1-20; B, 10-20; C, 20-40; D, >40). After adjusting for other cardiovascular risk factors, adjusted odds ratios for current smokers versus never-smokers as a control group were estimated for the presence of plaques, significant stenosis, and non-calcified plaques (NCP). Current smokers had a statistically significant higher prevalence of any plaque, significant stenosis, NCP, and coronary artery calcium score >100 than never-smokers. According to each categorization of TPY, SD, and CPD, the subclinical coronary atherosclerosis risk increased as grades increased in asymptomatic current smokers relative to never-smokers after adjusting for variable clinical and chemical risk factors. Our study suggests a cigarette dose-response relationship between current smoking and coronary atherosclerosis in asymptomatic individuals.
当前吸烟是无症状个体冠状动脉粥样硬化的强有力的独立预测因子。许多研究人员提出了吸烟与亚临床冠状动脉粥样硬化之间的香烟剂量反应关系。我们的研究目的是：(a) 调查无症状吸烟者冠状动脉粥样硬化的患病率和斑块特征；(b) 使用冠状动脉 CT 血管造影（CTA）评估吸烟与亚临床冠状动脉粥样硬化之间的香烟剂量反应关系。我们连续纳入了 7104 名作为一般健康评估一部分接受冠状动脉 CTA 的无症状患者。将当前吸烟者（n=1784）根据总吸烟包年数（TPY）分为四个等级（A：0.1-10；B：10-20；C：20-30；D：>30），根据吸烟年限（SD）分为四个等级（A：0.1-10；B：10-20；C：20-30；D：>30），根据每天吸烟支数（CPD）分为四个等级（A：1-20；B：10-20；C：20-40；D：>40）。在调整了其他心血管危险因素后，估计了当前吸烟者与从不吸烟者（对照组）之间斑块、显著狭窄和非钙化斑块（NCP）存在的比值比。与从不吸烟者相比，当前吸烟者的任何斑块、显著狭窄、NCP 和冠状动脉钙评分>100 的患病率均具有统计学意义。根据 TPY、SD 和 CPD 的每种类别，在调整了可变的临床和化学危险因素后，与从不吸烟者相比，无症状当前吸烟者的亚临床冠状动脉粥样硬化风险随着等级的升高而增加。我们的研究表明，在无症状个体中，当前吸烟与冠状动脉粥样硬化之间存在香烟剂量反应关系。
