AMSTERDAM – A prospective analysis of CT angiography of more than 13,000 patients bears some good news and some bad news for patients who have quit smoking, and yet another warning for those who continue to smoke.
Current smokers had nearly a twofold increase in risk of major adverse cardiac events (MACE), compared with those who had quit and those who had never smoked. However, they – along with past smokers – still had a significantly higher prevalence, extent, and severity of coronary artery disease (CAD), compared with individuals who never smoked.
The unpublished study, which is from the CONFIRM Registry, was presented by Dr. James K. Min of Weill Cornell Medical College, New York, and New York-Presbyterian Hospital, at the annual congress of the European Society of Cardiology.
Researchers evaluated the extent and severity of CAD, as well as the risk of MACE, for active smokers, past smokers, and nonsmokers undergoing coronary CT angiography.
Of the 13,372 patients without known CAD who underwent CT, 21% were current smokers, 24% were past smokers who had quit more than 3 months prior to the CT, and 55% were nonsmokers.
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Current smokers had a higher risk of major adverse cardiac events than did nonsmokers
The average age of the patients was 56 years, and half were men. Patients were followed up for 2 years, and MACE occurred in 279 cases (2.1%).
Analysis showed that current and past smokers had a 50% or higher risk of obstructive CAD than did nonsmokers. One-vessel disease had a frequency of 11.1% among nonsmokers, compared with 16.6% and 16.2% in current and past smokers, respectively; the frequency of two-vessel disease was 4.8% among nonsmokers vs. 7.3% and 7.8%; and the frequency of three-vessel disease was 2.3% vs. 5.1% and 5%.
In addition, current smokers had a higher risk of MACE than did nonsmokers (P less than .001), but past smokers did not (P = .29).
Even after matched-cohort analysis, the relationship remained the same, and current smoking was still significantly associated with MACE risk, but past smoking was not.
"You’re never too old to quit smoking," said Dr. Freek Verheugt, who moderated the session.
Dr. Min and Dr. Verheugt had no disclosures.
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