Most Common Additional Risk Factors of Coronary Artery Disease in Smoker Patients Specifically: Shedding Light on Smoker's Angiographic Profile (original) (raw)
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European heart journal, 2015
We evaluated coronary artery disease (CAD) extent, severity, and major adverse cardiac events (MACEs) in never, past, and current smokers undergoing coronary CT angiography (CCTA). We evaluated 9456 patients (57.1 ± 12.3 years, 55.5% male) without known CAD (1588 current smokers; 2183 past smokers who quit ≥3 months before CCTA; and 5685 never smokers). By risk-adjusted Cox proportional-hazards models, we related smoking status to MACE (all-cause death or non-fatal myocardial infarction). We further performed 1:1:1 propensity matching for 1000 in each group evaluate event risk among individuals with similar age, gender, CAD risk factors, and symptom presentation. During a mean follow-up of 2.8 ± 1.9 years, 297 MACE occurred. Compared with never smokers, current and past smokers had greater atherosclerotic burden including extent of plaque defined as segments with any plaque (2.1 ± 2.8 vs. 2.6 ± 3.2 vs. 3.1 ± 3.3, P < 0.0001) and prevalence of obstructive CAD [1-vessel disease (VD...
Benha Journal of Applied Sciences, 2023
Background:Smoking and passive smoking have been identified as variable risk factors for AMI and CAD,smoking plays a major role in premature coronary atherosclerosis and in accelerating atherosclerosisby increasing the oxidation of LDL and damaging coronary endothelial vasodilation. The purpose of this study is toassess coronary atheroscleroticplaque characteristics including (site, extent, nature and length)by computed tomographic angiography in smokers compared to non-smokers.. Methods:This cross sectional, single center study was conducted at atkobri El koba military hospital during the period from December 2019 to July 2021This study included 200 male patients withsuspectedCAD scheduled for coronary CT angiography. They were divided into two equal groups. The first group included smokers and the second group included non-smokers. Results: The smokers' grouphad a significantly higher prevalence of CADcompared to non-smokers' group.There was no significant statistical difference between the two groups regarding number of affected vessel if it was single or multiple vessels.Middle RCA, Left Main artery, Proximal LAD and Mid LAD were more affected among smokers). Comparison of thenature of obstruction showed that therate of obstruction was higher among smokers, as well calcific plaques were the most prevalent type among smokers, however it was more common in non-smokers.Conclusion:Compared to the non-smokers, smokers had a considerably greater prevalence of CAD in our research. The severity of coronary blockage was greater in smokers than in nonsmokers. CCTA is a potential non-invasive method that may detect coronary artery stenosis and rule out coronary artery disease, as well as evaluate the features of atherosclerotic plaques.
Pakistan Heart Journal, 2022
Objectives: Despite widespread use of smokeless tobacco (ST) in Pakistan, a very limited empirical evidence have been reported regarding its impact on the coronary anatomy and obstructions. Therefore, this study was conducted to compare the coronary angiographic profile of smokeless tobacco (ST) users and smokers with non-tobacco users presented with acute myocardial infarction (AMI). Methodology: Consecutive patients with AMI were stratified in to four groups as tobacco nonusers (G1), solo ST users (G2), both smoking and ST users (G3), and solo smokers (G4). Coronary angiographic findings regarding number of diseases vessels and infarct related artery were recorded. Results: Out of 326 patients, ST users were 28.2%(92), 6.4%(21) in conjunction with smoking and reaming 21.8%(71) without smoking. Females were 19.7%(14/71) of G2, 4.8%(1/21) of G3, 0% in G4. Young patients (≤ 40 years) were 3.4%(5/149) of G1, 9.9%(7/71) of G2, 14.1%(12/85) of G4, and 23.8%(5/21) of G3 cumulatively making 82.8%(24/29) of the young patients. Single vessel disease (SVD) and left anterior descending artery (LAD) were significantly higher among ST user as compared to non-users with distribution of 46.7% vs. 34.2% and 70.7% vs. 56.4% respectively. Conclusion: The distribution and localization of involved vessels among ST users with AMI are same as that of smokers with SCD and LAD as infarct artery as the common findings. Tendency of ST use is also high among female patients and Tobacco use in either form, smoking or smokeless, is alarmingly high (>80%) among young (≤40 years) patients with AMI .
Impact of smoking on acute phase outcomes of myocardial infarction
Coronary Artery Disease, 2011
Objectives Previous studies have found an apparent paradox in smokers: acute phase outcomes after an acute myocardial infarction are superior to those of nonsmokers. Furthermore, it is reported that smoking has an impact on the metabolism of clopidogrel. This study aimed to examine whether this paradoxical finding exists in patients who undergo drug-eluting stent implantation and are treated with clopidogrel. Methods From April 2003 to June 2010, 1424 consecutive patients with acute myocardial infarction who underwent primary or rescue percutaneous coronary intervention with drug-eluting stent and clopidogrel were enrolled. They were divided into three groups: current smokers (n = 486); previous smokers (n = 349); and nonsmokers (n = 589). The primary end point was a composite of 30-day, all-cause death, nonfatal myocardial infarction, or definite stent thrombosis. Results Compared with nonsmokers, current smokers were younger (P < 0.001) and more often men (P < 0.001). They had larger myocardial infarctions than did nonsmokers [maximum troponin I, 8.9 (2.4, 38.4) vs. 6.8 (1.4, 30.1) ng/ml, P = 0.01]. Current smokers less frequently met the primary end point than did nonsmokers (2.9 vs. 6.1%, P = 0.01). However, after adjustment for baseline and angiographic characteristics, the beneficial effect of smoking was no longer seen (odds ratio 1.35, confidence interval: 0.53-3.44, P = 0.5). Conclusion A beneficial effect of smoking ('smoker's paradox') in the unadjusted primary end point continues to be present; however, after adjustment for differences in baseline characteristics, no benefit was detectable. Coron Artery Dis 22:217-222 c 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.
Impact of Cigarette Smoking: a 3-Year Clinical Outcome of Vasospastic Angina Patients
Korean Circulation Journal, 2016
Background and Objectives: Cigarette smoking is a risk significant factor in coronary artery disease (CAD) and vasospastic angina (VSA). However, it is largely unknown whether smoking adds to any long-term clinical risk in VSA patients. Subjects and Methods: A total of 2797 patients without significant CAD underwent acetylcholine (Ach) provocation test between November 2004 and October 2010. Patients were divided into three groups, based on the presence of coronary artery spasm (CAS) and smoking habits (non-CAS group: n=1188, non-smoking CAS group: n=1214, smoking CAS group: n=395). All CAS patients were prescribed with anti-anginal medications for at least 6 months. The incidence of major clinical outcomes and recurrent angina of these groups were compared up to 3 years. Results: There were considerable differences in the baseline clinical and angiographic characteristics among the three groups, but there was no difference in the endpoints among the three groups (including individual and composite hard endpoints) such as death, myocardial infarction, de novo percutaneous coronary intervention, cerebrovascular accident, and major adverse cardiac events. However, there was a higher incidence of recurrent angina in both the non-smoking CAS group and smoking CAS group, as compared to the non-CAS group. In multivariable adjusted Cox-proportional hazards regression analysis, smoking CAS group exhibited a higher incidence of recurrent angina compared with the non-CAS group (hazard ratio [HR]; 2.46, 95% confidence interval [CI]; 1.46-4.14, p=0.001) and nonsmoking CAS group (HR; 1.76, 95% CI; 1.08-2.87, p=0.021). Conclusion: Cigarette smoking CAS group exhibited higher incidence of recurrent angina during the 3-year clinical follow-up compared with both the non-CAS group and non-smoking CAS group. Quitting of smoking, paired with intensive medical therapy and close clinical follow-up, can help to prevent recurrent angina.
Tobacco smoke exposure and endothelial dysfunction in patients with advanced coronary artery disease
Polskie Archiwum Medycyny Wewnętrznej, 2013
Exposure to tobacco smoke is associated with a higher cardiovascular risk, especially in patients with coronary artery disease (CAD). The aim of the study was to evaluate the effect of active and passive tobacco smoking on the activity of endothelial markers in advanced atherosclerosis. We studied 181 consecutive patients with advanced CAD (53 women and 128 men) aged 60 ±8 years, including 102 active self‑declared smokers (56.3%). We determined plasma asymmetric dimethylarginine (ADMA), thrombomodulin (TM), and plasminogen activator inhibitor‑1 (PAI‑1) levels, along with serum cotinine concentrations as a marker of tobacco smoking. Plasma ADMA levels were higher in active smokers compared with nonsmokers (0.60 ±0.09 μmol/l vs. 0.49 ±0.08 μmol/l, P <0.001). There were similar intergroup differences in TM (4.60 ±2.11 ng/ml vs. 3.0 ±1.7 ng/ml, P <0.0001) and PAI‑1 levels (30.3 ±12.4 ng/ml vs. 23.6 ±11.3 ng/ml, P <0.0001). We observed positive correlations between cotinin...
Stroke, 2009
Background and Purpose-The purpose of this study was to evaluate the effects of timing and extent of smoking, type of cigarettes, and concomitant vascular risk factors (VRFs) on the association between smoking and carotid intima-media thickness (C-IMT) in a lipid clinic population. Methods-1804 patients (869 men, age 21 to 85 year) participated in the study. Smoking habits were recorded and C-IMTs were measured by B-mode ultrasound. The associations of C-IMT with smoking status (never, former, and current) and with the cigarettes' content of tar, nicotine, and carbon monoxide (alone or combined to define "light" or "regular" cigarettes) as well as the interactions between smoking status, gender, and VRFs were evaluated before and after adjustment for confounders.