Effect of smoking status on coronary artery disease among Chinese post-menopausal women.

Abstract

Smoking is a prominent risk factor of cardiovascular diseases. The occurrence of myocardial infarction and mortality in smokers with cardiovascular diseases is several times higher than that in non-smokers. Smoking is associated with gender-independent enhanced mortality. We determined the effect of smoking status on coronary artery disease (CAD) and coronary computed tomography angiography (CCTA) in Chinese post-menopausal women. Among these patients, those with significant CAD (≥50% luminal narrowing) were further classified into one-, two-, or three-vessel disease according to CCTA results. The following events were recorded: all-cause mortality, non-fatal infarction and unstable angina. 2332 patients evaluated with CCTA included 1668 never smokers (71.5%), 475 former smokers (20.4%), and 189 current smokers (8.1%). The current smokers exhibit greater luminal narrowing as observed on CCTA (p<0.001) than the other subjects. During the median 685±269.8days follow-up period, never-smoking women have a low incidence of events, whereas former and current smokers are associated with an increased incidence of such event (p<0.001). Furthermore, current smoking and the presence of multiple-vessel disease on CCTA are independently associated with the events in the logistic regression analysis. Smoking status is related to significant CAD and luminal narrowing on CCTA in the Chinese post-menopausal smoking women. In addition, current smoking and the presence of multiple-vessel disease on CCTA can independently predict events of all-cause mortality, non-fatal infarction or unstable angina.