title: Coronary CT angiography findings based on smoking status: Do ex-smokers and never-smokers share a low probability of developing coronary atherosclerosis?
abstract: The relationship of coronary artery disease (CAD) in ex-smokers has not been elucidated, although smoking is considered to be one of the major risk factors of CAD. We investigate subclinical coronary atherosclerosis (SCA) in asymptomatic subjects with coronary computed tomography angiography (CCTA), according to smoking status, and determine whether ex-smokers share a low probability of developing CAD with never-smokers. We retrospectively enrolled 6930 self-referred asymptomatic adults who underwent both coronary artery calcium score (CACS) and CCTA. The prevalence and characteristics of SCA were assessed according to smoking status (never-, ex- and current smokers). After adjusting for variable risk factors, we used multivariate logistic regression for adjusted odds ratios (AOR) of high CACS (>100), SCA (any plaque), significant stenosis (>50 % in luminal stenosis) and each plaque type (non-calcified, mixed and calcified plaque) among the three groups. The prevalence of SCA was highest in the ex-smokers (35.4 %) and the prevalence of significant stenosis in ex-smokers (6.9 %) was as high as in current smokers (6.4 %). However, after adjusting for variable risk factors, SCA was significantly correlated with both ex-smokers (AOR; 1.21) and current smokers (AOR; 1.25), whereas significant stenosis was correlated only with current smokers (AOR; 1.91). The association between SCA and ex-smokers is as strong as with current smokers, although significant stenosis is only correlated with current smokers; thus, not only quitting smoking but also never initiating smoking would be helpful to reduce the progression of the SCA.
authors.affiliation: Department of Radiology, Seoul Medical Center, Seoul, Korea.
authors.forename: Minkyung
authors.initials: M
authors.lastname: Yi
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital, Gyeonggido, Seoul, 436-707, Korea. drejchun@hanmail.net.
authors.forename: Eun Ju
authors.initials: EJ
authors.lastname: Chun
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital, Gyeonggido, Seoul, 436-707, Korea.
authors.forename: Min Su
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Medical Research Collaborating Center, Seoul National University Bundang Hospital, Seoul, Korea.
authors.forename: Jaebong
authors.initials: J
authors.lastname: Lee
authors.affiliation: Division of Cardiovascular Imaging, Department of Radiology, Seoul National University Bundang Hospital, Gyeonggido, Seoul, 436-707, Korea.
authors.forename: Sang Il
authors.initials: SI
authors.lastname: Choi
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000453:epidemiology; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects* / Q000453:epidemiology; D016540:Smoking Cessation; D000074606:Smoking Prevention
keywords: Coronary artery disease; Ex-smoker; Multi-detector CT; Smoking