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Effect of cigarette smoking on carotid artery atherosclerosis: a community-based cohort study

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Abstract

Cigarette smoking is closely associated with the development of cardiovascular diseases. However, the relationship between cigarette smoking and subclinical atherosclerosis has not been fully studied. We sought to clarify the association between cigarette smoking and carotid intima-media thickness (cIMT) in a general Japanese population. Among 1,209 participants who received a medical check-up with cardiovascular examination at our institution, 450 participants (37.2%) were smokers (including both past and current smokers). We evaluated cIMT as a marker of subclinical atherosclerosis. The value of cIMT and rate of carotid plaque defined as IMT ≥ 1.1 mm did not differ between smokers and never smokers. However, the rate of carotid high-risk atheroma, defined as carotid artery atheroma including hypoechoic dominant and ulceration, was significantly higher among smokers than never smokers (30.4%, vs 23.6%, p = 0.009). Even after adjustment for covariates, cigarette smoking was independently associated with high-risk atheroma formation (odds ratio 1.384, 95% CI 1.019–1.880; p = 0.038). The value of cIMT and the rate of high-risk atheroma were significantly higher in smokers than never smokers in the subgroup of participants aged ≥ 60 years, whereas the rate of high-risk atheroma only was higher in smokers than never smokers in the subgroup of participants aged < 60 years. In conclusion, the development of high-risk carotid artery atheroma may precede the thickening of cIMT in cigarette smokers, which suggests the novel insight for the pathological mechanism underlying cardiovascular events and cigarette smoking.

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Acknowledgements

Many thanks to all staff of the Center for Preventive Medicine at The University of Tokyo Hospital.

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hiroyuki Kiriyama, Hidehiro Kaneko, Hidetaka Itoh, Yuriko Yoshida, Koki Nakanishi, Yoshiko Mizuno, Masao Daimon, Hiroyuki Morita & Issei Komuro

  2. Department of Advanced Cardiology, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan

    Hidehiro Kaneko

  3. Department of Clinical Laboratory, The University of Tokyo Hospital, Tokyo, Japan

    Masao Daimon

  4. Center for Epidemiology and Preventive Medicine, The University of Tokyo Hospital, Tokyo, Japan

    Yoshiko Mizuno & Nobutake Yamamichi

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  1. Hiroyuki Kiriyama
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Correspondence to Hidehiro Kaneko.

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Kiriyama, H., Kaneko, H., Itoh, H. et al. Effect of cigarette smoking on carotid artery atherosclerosis: a community-based cohort study. Heart Vessels 35, 22–29 (2020). https://doi.org/10.1007/s00380-019-01455-5

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