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Original article Association between smoking status and subclinical coronary atherosclerosis in asymptomatic individuals
Hyeji Lee1orcid , Jinhee Ha1orcid , Kyung Sun Park1orcid , Young-Jee Jeon1orcid , Sangwoo Park1orcid , Soe Hee Ann1orcid , Yong-Giun Kim1orcid , Yongjik Lee1orcid , Woon Jung Kwon1orcid , Seong Hoon Choi1orcid , Seungbong Han2orcid , Gyung-Min Park1orcid
Epidemiol Health 2024;e2024064
DOI: https://doi.org/10.4178/epih.e2024064 [Accepted]
Published online: July 16, 2024
1Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
2College of Medicine, Korea University, Seoul, Korea
Corresponding author:  Seungbong Han,
Email: min8684@hanmail.net
Gyung-Min Park,
Email: min8684@hanmail.net
Received: 2 April 2024   • Revised: 28 June 2024   • Accepted: 5 July 2024
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Abstract

OBJECTIVES
In this study, we sought to evaluate the association between smoking status and subclinical coronary atherosclerosis, as detected by coronary computed tomography angiography (CCTA), in asymptomatic individuals.
METHODS
We retrospectively analyzed 9,285 asymptomatic participants (mean age, 53.7±8.0 years; 6,017 [64.8%] male) with no history of coronary artery disease (CAD) who had undergone self-referred CCTA. Of these participants, 4,333 (46.7%) were considered never smokers, 2,885 (31.1%) former smokers, and 2,067 (22.3%) current smokers. We assessed the degree and characteristics of subclinical coronary atherosclerosis using CCTA, with obstructive CAD defined as a diameter stenosis of at least 50%.
RESULTS
Compared with never-smokers, former smokers exhibited no significant differences in the probabilities of obstructive CAD, any coronary plaque, calcified plaque, or mixed plaque, as determined using adjusted odds ratios (aORs; p>0.05 for all). However, the risk of non-calcified plaque was significantly higher in former smokers (aOR, 1.34; 95% confidence interval [CI], 1.00 to 1.78; p=0.048). Current smokers had significantly higher rates of obstructive CAD (aOR, 1.46; 95% CI, 1.10 to 1.96; p=0.010), any coronary plaque (aOR, 1.41; 95% CI, 1.20 to 1.65; p<0.001), calcified plaque (aOR, 1.32; 95% CI, 1.13 to 1.55; p=0.001), non-calcified plaque (aOR, 1.72; 95% CI, 1.28 to 2.32; p<0.001), and mixed plaque (aOR, 2.00; 95% CI, 1.39 to 2.86; p<0.001) compared to never smokers.
CONCLUSIONS
This cross-sectional study revealed a significant association between current smoking and subclinical coronary atherosclerosis, as detected on CCTA. Additionally, former smoking demonstrated an association with non-calcified plaque, indicating elevated cardiovascular risk.

Epidemiol Health : Epidemiology and Health
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