Association between smoking status and subclinical coronary atherosclerosis in asymptomatic men

Abstract Background We sought to evaluate the association between smoking status and subclinical coronary atherosclerosis on coronary computed tomographic angiography (CCTA) in asymptomatic men. Methods We analyzed 6,017 asymptomatic men (mean age 53.2±8.0 years) with no history of coronary artery disease who voluntarily underwent CCTA. Among the study participants, 1,200 (19.9%), 2,828 (47.0%), and 1,989 (33.1%) were categorized as never, former, and current smokers, respectively. The degree and extent of subclinical coronary atherosclerosis were assessed by CCTA, and a degree of stenosis ≥50% was defined as significant. Logistic regression analysis was used to determine the association between smoking status and subclinical coronary atherosclerosis. Results Compared with never smokers, there were no statistically significant differences in the adjusted odds ratios (ORs) of former smokers for significant coronary artery stenosis, any coronary, calcified, and mixed plaque (p>0.05 for all). However, the adjusted ORs for non-calcified plaque (1.383; 95% confidence interval [CI] 1.024–1.866; p=0.034) were significantly higher in the former smokers. For current smokers, the adjusted ORs for significant coronary artery stenosis (1.481; 95% CI 1.099–1.996; p=0.010), any coronary plaque (1.354; 95% CI 1.149–1.595; p<0.001), calcified plaque (1.261; 95% CI 1.069–1.488; p=0.006), non-calcified plaque (1.759; 95% CI 1.283–2.412; p<0.001), and mixed plaque (2.100; 95% CI 1.444–3.054; p<0.001) were significantly higher than those of never smokers. Conclusions Among asymptomatic men, current smokers had a significant association with subclinical coronary atherosclerosis on CCTA. Former smokers were also associated with non-calcified plaque, suggesting an increased cardiovascular risk.