Associations of cigarette smoking and burden of thoracic aortic calcification in asymptomatic individuals: A dose-response relationship

Autoři: Jui-Peng Tsai aff001;  Ya-Ting Jan aff001;  Chun-Ho Yun aff003;  Kuo-Tzu Sung aff001;  Chuan-Chuan Liu aff006;  Jen-Yuan Kuo aff002;  Chung-Lieh Hung aff002;  Tung-Hsin Wu aff001;  Jiun-Lu Lin aff009;  Charles Jia-Yin Hou aff002;  Hung-I Yeh aff002;  Hiram G. Bezerra aff010;  Aaron So aff011
Působiště autorů: Department of Biomedical Imaging and Radiological Sciences, National Yang Ming University, Taipei, Taiwan aff001;  Division of Cardiology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan aff002;  Department of Medicine, Mackay Medical College, Taipei, Taiwan aff003;  Mackay Junior College of Medicine, Nursing and Management, Taipei, Taiwan aff004;  Department of Radiology, MacKay Memorial Hospital, Taipei, Taiwan aff005;  Graduate Institute of Health Care Organization Administration, College of Public Health National Taiwan University, Taipei, Taiwan aff006;  Health Evaluation Center, MacKay Memorial Hospital, Taipei, Taiwan aff007;  Department of Medical Technology, Yuanpei University of Science and Technology, Hsin-Chu, Taiwan aff008;  Division of Endocrinology and Metabolism, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan aff009;  Cardiovascular Department, University Hospitals Case Medical Center, Cleveland, OH, United States of America aff010;  Imaging Program, Lawson Health Research Institute, London, Ontario, Canada aff011;  Department of Medical Biophysics, University of Western Ontario, London, Ontario, Canada aff012
Vyšlo v časopise: PLoS ONE 15(1)
Kategorie: Research Article
doi: 10.1371/journal.pone.0227680


Smoking is known as a powerful predictor of pathological coronary atherosclerosis. Thoracic aortic calcification (TAC), an alternative marker for pathological atherosclerosis, has also been shown to be associated unfavorable cardiovascular outcomes. We aimed to investigate the dose-response relationship between cigarette use and calcification burden in subjects free from clinical symptoms. Among 3109 patients enrolled in this analysis, we categorized study participants according to smoking exposure pattern as: non-smokers, ex-smokers and current smokers. Smoking dose (cigarette/day), duration (years) and pack-years were semi-quantified as smoking dose exposure variables. Thoracic aortic calcification burden (including TAC score, plaque volume and plaque density) were determined and related to smoking dose and pattern information. TAC burdens (including TAC score, plaque volume and density) were highest in current smoker compared to non-smoker group, with ex-smoker showing TAC burdens in-between (all ANOVA p<0.05). Linear regression models consistently demonstrated that TAC burdens as continuous variables were independently higher in a dose-dependent manner with smoking exposure, particularly in high-dose (> 10 cigarettes/day) and the long-duration (> 3 years) smokers, even after adjusting for baseline demographic differences (all p<0.05). By logistic regression, subjects who never smoke consistently demonstrated reduced risk of TAC existence (adjusted OR: 0.65 [95% CI: 0.48–0.86], P = 0.003) in contrary to those current smokers (adjusted OR: 1.47 [95% CI: 1.10–1.89], P = 0.009). A dose-response relationship between active cigarette use and TAC burden was observed, with those who never exposed to smoking or quitted demonstrating partial protective effects. Our data provided imaging-based evidence about the potential deleterious biological hazards of long-term and high-dose cigarette consumption.

Klíčová slova:

Aorta – Blood pressure – Calcification – Cardiovascular diseases – Computed axial tomography – Coronary heart disease – Medical risk factors – Smoking habits


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