Associations between smoking habits and major adverse cardiovascular events in patients who underwent coronary computed
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ORIGINAL ARTICLE
Associations between smoking habits and major adverse cardiovascular events in patients who underwent coronary computed tomography angiography as screening for coronary artery disease Sara Higashi1 · Yuhei Shiga1 · Masaya Yano1 · Tomoki Imaizumi1 · Kohei Tashiro1 · Yoshiaki Idemoto1 · Yuta Kato1 · Takashi Kuwano1 · Makoto Sugihara1 · Shin‑ichiro Miura1,2 Received: 7 May 2020 / Accepted: 6 November 2020 © Springer Japan KK, part of Springer Nature 2020
Abstract We analyzed whether smoking was associated with major adverse cardiovascular events (MACE) and the progression of coronary atherosclerosis as assessed by coronary computed tomography angiography (CCTA) as screening for coronary artery disease (CAD). We enrolled 443 patients who had all undergone CCTA and either were clinically suspected of having CAD or had at least one cardiovascular risk factor. We divided the patients into smoking (past and current smoker) and non-smoking groups and into males and females, and evaluated the presence of CAD, severity of coronary atherosclerosis and MACE (cardiovascular death, ischemic stroke, acute myocardial infarction and coronary revascularization) with a follow-up of up to 5 years. %CAD and the severity of coronary atherosclerosis in the smoking group were significantly higher than those in the non-smoking group. %MACE in males and smokers were significantly higher than those in females and non-smokers, respectively. Interestingly, Kaplan–Meier curves also showed that female non-smokers enjoyed significantly greater freedom from MACE than female smokers (p = 0.007), whereas there was no significant difference in freedom from MACE between male non-smokers and male smokers (p = 0.984). Although there were no significant predictors of MACE in all patients according to a multiple logistic regression analysis, smoking was useful for predicting MACE in females, but not males. In conclusion, smoking was significantly associated with MACE in females, but not males, who underwent CCTA as screening for CAD. Keywords Smoking · Coronary artery disease · Coronary computed tomography angiography · Major adverse cardiovascular events
Introduction Thrombosis underlies most acute complications of atherosclerosis, notably unstable angina and acute myocardial infarction (AMI) [1]. Inflammation plays a decisive role in the pathophysiology of these acute thrombotic events. Sara Higashi and Yuhei Shiga contributed equally to this manuscript. * Shin‑ichiro Miura [email protected]‑u.ac.jp 1
Department of Cardiology, Fukuoka University School of Medicine, 7‑45‑1 Nanakuma, Jonan‑ku, Fukuoka 814‑0180, Japan
Department of Cardiology, Fukuoka University Nishijin Hospital, Fukuoka, Japan
2
Smoking, like hypertension (HTN), dyslipidemia (DL), diabetes mellitus (DM) and obesity, is related to coronary atherosclerotic cardiovascular disease (ASCVD) and is associated with an increased risk of the onset of atherosclerotic cardiovascular diseases such as cerebral infarction, coronary artery disease (CAD) and peripheral arte
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