Prakash Vineet, Jaker Sams, Burgan Amjad, Jacques Adam, Fluck David, Sharma Pankaj, Fry Christopher H, Han Thang S
Department of Radiology, Ashford & St Peter's Foundation Trust, Chertsey, UK.
Diagnostic Imaging, Royal Surrey County Hospital, Guildford, UK.
JRSM Cardiovasc Dis. 2021 Mar 15;10:2048004020980945. doi: 10.1177/2048004020980945. eCollection 2021 Jan-Dec.
Smoking and dyslipidaemia are known individual risk factors of coronary artery disease (CAD). The present study examined the combined risk of smoking and dyslipidaemia on coronary atherosclerosis.
Coronary artery calcium (CAC), measured by cardiac CT, was used to assess the extent of CAD, which was related to smoking and dyslipidaemia using logistic regression, adjusted for age, sex, hypertension, BMI and family history of ischaemic heart disease.
Seventy-one patients (46 men, 25 women: median age of 53.7yrs; IQR = 47.0-59.5) were recruited. The mean log CAC score in never-smokers without dyslipidaemia (reference group) was 0.37 (SD = 0.73), while the value in those with a history of smoking was 0.44 ± 0.48 (mean difference: 0.07, 95%CI:-0.67 to 0.81, = 0.844), dyslipidaemia was 1.07 ± 1.08 (mean difference: 0.71, 95%CI: 0.24 to 1.17, = 0.003), and both risk factors was 1.82 ± 0.64 (mean difference: 1.45, 95%CI:0.88 to 2.02, < 0.001). For individuals in the reference group, the proportions with none, one and multiple vessel disease were 80.6%, 16.1% and 3.2%; for those with a history of smoking or with dyslipidaemia were 50.0%, 25.0% and 25.0%; and for those with both risk factors were 8.3%, 25.0% and 66.7%. Patients with a history of both risk factors had greater adjusted risks of having one- vessel disease - OR = 14.3 (95%CI = 2.1-98.2) or multiple vessel disease: OR = 51.8 (95%CI = 4.2-609.6).
Smoking and dyslipidaemia together are associated with high coronary artery calcification and CAD, independent of other major risk factors.
吸烟和血脂异常是已知的冠状动脉疾病（CAD）的个体危险因素。本研究探讨了吸烟和血脂异常对冠状动脉粥样硬化的联合风险。
通过心脏CT测量冠状动脉钙化（CAC），以评估CAD的程度，并使用逻辑回归分析其与吸烟和血脂异常的关系，同时对年龄、性别、高血压、BMI和缺血性心脏病家族史进行了调整。
共招募了71名患者（46名男性，25名女性；中位年龄53.7岁；IQR = 47.0 - 59.5）。从不吸烟且无血脂异常的患者（参照组）的平均log CAC评分为0.37（标准差 = 0.73），有吸烟史的患者为0.44±0.48（平均差异：0.07，95%CI：-0.67至0.81，P = 0.844），有血脂异常的患者为1.07±1.08（平均差异：0.71，95%CI：0.24至1.17，P = 0.003），同时存在两种危险因素的患者为1.82±0.64（平均差异：1.45，95%CI：0.88至2.02，P < 0.001）。在参照组个体中，无血管病变、单支血管病变和多支血管病变的比例分别为80.6%、16.1%和3.2%；有吸烟史或血脂异常的患者分别为50.0%、25.0%和25.0%；同时存在两种危险因素的患者分别为8.3%、25.0%和66.7%。同时存在两种危险因素的患者发生单支血管病变的校正风险更高 - OR = 14.3（95%CI = 2.1 - 98.2）或多支血管病变：OR = 51.8（95%CI = 4.2 - 609.6）。
吸烟和血脂异常共同与高冠状动脉钙化和CAD相关，独立于其他主要危险因素。
