TY - JOUR
T1 - Associations of Cigarette Smoking With Subclinical Inflammation and Atherosclerosis
T2 - ELSA-Brasil (The Brazilian Longitudinal Study of Adult Health)
AU - Kianoush, Sina
AU - Yakoob, Mohammad Yawar
AU - Al-Rifai, Mahmoud
AU - Defilippis, Andrew P.
AU - Bittencourt, Marcio S.
AU - Duncan, Bruce B.
AU - Bensenor, Isabela M.
AU - Bhatnagar, Aruni
AU - Lotufo, Paulo A.
AU - Blaha, Michael J.
N1 - Funding Information:
This analysis was supported by funding from the American Heart Association Tobacco Regulation and Addiction Center (A-TRAC), NIH (1 P50 HL120163-01), a member of the FDA Tobacco Centers of Regulatory Science for Research Relevant to the Family Smoking Prevention and Tobacco Control Act (P50). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or the FDA. The ELSA-Brasil baseline study was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology and National Counsel of Technological and Scientific Development (CNPq) - National Research Council (grants # 01 06 0010.00 RS, 01 06 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ).
Publisher Copyright:
© 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
PY - 2017
Y1 - 2017
N2 - Background-—There is a need to identify sensitive biomarkers of early tobacco-related cardiovascular disease. We examined the association of smoking status, burden, time since quitting, and intensity, with markers of inflammation and subclinical atherosclerosis. Methods and Results-—We studied 14 103 participants without clinical cardiovascular disease in ELSA-Brasil (Brazilian Longitudinal Study of Adult Health). We evaluated baseline cross-sectional associations between smoking parameters and inflammation (highsensitivity C-reactive protein [hsCRP]) and measures of subclinical atherosclerosis (carotid intima–media thickness, ankle-brachial index, and coronary artery calcium [CAC]). The cohort included 1844 current smokers, 4121 former smokers, and 8138 never smokers. Mean age was 51.7±8.9 years; 44.8% were male. After multivariable adjustment, compared with never smokers, current smokers had significantly higher levels of hsCRP (b=0.24, 0.19–0.29 mg/L; P<0.001) and carotid intima–media thickness (b=0.03, 0.02–0.04 mm; P<0.001) and odds of ankle-brachial index ≤1.0 (odds ratio: 2.52; 95% confidence interval, 2.06–3.08; P<0.001) and CAC >0 (odds ratio: 1.83; 95% confidence interval, 1.46–2.30; P<0.001). Among former and current smokers, pack-years of smoking (burden) were significantly associated with hsCRP (P<0.001 and P=0.006, respectively) and CAC (P<0.001 and P=0.002, respectively). Among former smokers, hsCRP and carotid intima–media thickness levels and odds of ankle-brachial index ≤1.0 and CAC >0 were lower with increasing time since quitting (P<0.01). Among current smokers, number of cigarettes per day (intensity) was positively associated with hsCRP (P<0.001) and CAC >0 (P=0.03) after adjusting for duration of smoking. Conclusions-—Strong associations were observed between smoking status, burden, and intensity with inflammation (hsCRP) and subclinical atherosclerosis (carotid intima–media thickness, ankle-brachial index, CAC). These markers of early cardiovascular disease injury may be used for the further study and regulation of traditional and novel tobacco products.
AB - Background-—There is a need to identify sensitive biomarkers of early tobacco-related cardiovascular disease. We examined the association of smoking status, burden, time since quitting, and intensity, with markers of inflammation and subclinical atherosclerosis. Methods and Results-—We studied 14 103 participants without clinical cardiovascular disease in ELSA-Brasil (Brazilian Longitudinal Study of Adult Health). We evaluated baseline cross-sectional associations between smoking parameters and inflammation (highsensitivity C-reactive protein [hsCRP]) and measures of subclinical atherosclerosis (carotid intima–media thickness, ankle-brachial index, and coronary artery calcium [CAC]). The cohort included 1844 current smokers, 4121 former smokers, and 8138 never smokers. Mean age was 51.7±8.9 years; 44.8% were male. After multivariable adjustment, compared with never smokers, current smokers had significantly higher levels of hsCRP (b=0.24, 0.19–0.29 mg/L; P<0.001) and carotid intima–media thickness (b=0.03, 0.02–0.04 mm; P<0.001) and odds of ankle-brachial index ≤1.0 (odds ratio: 2.52; 95% confidence interval, 2.06–3.08; P<0.001) and CAC >0 (odds ratio: 1.83; 95% confidence interval, 1.46–2.30; P<0.001). Among former and current smokers, pack-years of smoking (burden) were significantly associated with hsCRP (P<0.001 and P=0.006, respectively) and CAC (P<0.001 and P=0.002, respectively). Among former smokers, hsCRP and carotid intima–media thickness levels and odds of ankle-brachial index ≤1.0 and CAC >0 were lower with increasing time since quitting (P<0.01). Among current smokers, number of cigarettes per day (intensity) was positively associated with hsCRP (P<0.001) and CAC >0 (P=0.03) after adjusting for duration of smoking. Conclusions-—Strong associations were observed between smoking status, burden, and intensity with inflammation (hsCRP) and subclinical atherosclerosis (carotid intima–media thickness, ankle-brachial index, CAC). These markers of early cardiovascular disease injury may be used for the further study and regulation of traditional and novel tobacco products.
KW - Atherosclerosis
KW - Inflammation
KW - Smoking
KW - Subclinical atherosclerosis risk factor
KW - Tobacco products
UR - http://www.scopus.com/inward/record.url?scp=85030648019&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030648019&partnerID=8YFLogxK
U2 - 10.1161/JAHA.116.005088
DO - 10.1161/JAHA.116.005088
M3 - Article
C2 - 28647689
AN - SCOPUS:85030648019
SN - 2047-9980
VL - 6
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 6
M1 - e005088
ER -