Epidemiology and Health

Original Articles

Association between smoking status and subclinical coronary atherosclerosis in asymptomatic Korean individuals: Hyeji Lee, Jinhee Ha, Kyung Sun Park, Young-Jee Jeon, Sangwoo Park, Soe Hee Ann, Yong-Giun Kim, Yongjik Lee, Woon Jung Kwon, Seong Hoon Choi, Seungbong Han, Gyung-Min Park; Epidemiol Health. 2024;46:e2024064. Published online July 16, 2024; DOI: https://doi.org/10.4178/epih.e2024064

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
In this study, we sought to evaluate the association between smoking status and subclinical coronary atherosclerosis, as detected by coronary computed tomography angiography (CCTA), in asymptomatic individuals.
METHODS
We retrospectively analyzed 9,285 asymptomatic participants (mean age, 53.7±8.0 years; n=6,017, 64.8% male) with no history of coronary artery disease (CAD) who had undergone self-referred CCTA. Of these participants, 4,333 (46.7%) were considered never smokers, 2,885 (31.1%) former smokers, and 2,067 (22.3%) current smokers. We assessed the degree and characteristics of subclinical coronary atherosclerosis using CCTA, with obstructive CAD defined as a diameter stenosis of at least 50%.
RESULTS
Compared with never-smokers, former smokers exhibited no significant differences in the probabilities of obstructive CAD, any coronary plaque, calcified plaque, or mixed plaque, as determined using adjusted odds ratios (aORs; p>0.05 for all). However, the risk of non-calcified plaque was significantly higher in former smokers (aOR, 1.34; 95% confidence interval [CI], 1.00 to 1.78; p=0.048). Current smokers had significantly higher rates of obstructive CAD (aOR, 1.46; 95% CI, 1.10 to 1.96; p=0.010), any coronary plaque (aOR, 1.41; 95% CI, 1.20 to 1.65; p<0.001), calcified plaque (aOR, 1.32; 95% CI, 1.13 to 1.55; p=0.001), non-calcified plaque (aOR, 1.72; 95% CI, 1.28 to 2.32; p<0.001), and mixed plaque (aOR, 2.00; 95% CI, 1.39 to 2.86; p<0.001) compared to never smokers.
CONCLUSIONS
This cross-sectional study revealed a significant association between current smoking and subclinical coronary atherosclerosis, as detected on CCTA. Additionally, former smoking demonstrated an association with non-calcified plaque, indicating elevated cardiovascular risk.; Summary

Korean summary
- 현재흡연은 무증상 관상동맥 죽상경화증의 독립적인 예측 인자이다. - 과거흡연은 초기 죽상경화증과 취약성을 반영하는 비석회화 플라크와 관련이 있다. - 무증상 관상동맥 죽상경화증을 예방하기 위해 적절한 금연 전략이 필요하다.

Key Message
- Current smoking is an independent predictor of subclinical coronary atherosclerosis. - Former smoking is associated with non-calcified plaque reflecting the early atherosclerosis and vulnerability. - Appropriate strategies for smoking cessation are needed to prevent subclinical coronary atherosclerosis.

The association between the socioeconomic deprivation level and ischemic heart disease mortality in Japan: an analysis using municipality-specific data: Tasuku Okui, Tetsuya Matoba, Naoki Nakashima; Epidemiol Health. 2022;44:e2022059. Published online July 14, 2022; DOI: https://doi.org/10.4178/epih.e2022059

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2 Web of Science
2 Crossref

Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
Geographical variation in the standardized mortality ratio (SMR) for ischemic heart disease (IHD) among municipalities has not been assessed in Japan. Additionally, associations between area-level socioeconomic deprivation indices and IHD mortality have not been identified in Japan. The present study investigated this association.

METHODS

Information on IHD mortality was extracted from Vital Statistics data from 2018 to 2020 for each municipality in Japan. The socioeconomic deprivation level was derived from multiple socioeconomic characteristics. We classified municipalities into quintiles based on the deprivation level and investigated the association between the deprivation level and the SMR of IHD. Additionally, a Bayesian spatial regression model was used to investigate this association, adjusting for other municipal characteristics.

RESULTS

Geographical variation in the SMR of IHD was revealed, and municipalities with high SMRs were spatially clustered. There was a weak negative correlation between the socioeconomic deprivation level and the SMRs (correlation coefficient, -0.057 for men and -0.091 for women). In contrast, the regression analysis showed a statistically significant positive association between deprived areas and the IHD mortality rate, and the relative risks for the most deprived municipalities compared with the least deprived municipalities were 1.184 (95% credible interval [CrI], 1.110 to 1.277) and 1.138 (95% CrI, 1.048 to 1.249) for men and women, respectively.

CONCLUSIONS

A weak negative correlation between the socioeconomic deprivation level and the SMR was observed in the descriptive analysis, while the regression analysis showed that living in deprived areas was statistically positively associated with the IHD mortality rate.

Summary

Key Message
We investigated associations between area-level socioeconomic deprivation indices and IHD mortality in Japan using the Vital Statistics data, and a spatial regression analysis showed that living in deprived areas was statistically positively associated with the IHD mortality rate.

Citations

Citations to this article as recorded by

Area deprivation and premature cardiovascular mortality: a nationwide population-based study in South Korea
Eunji Kim, Hokyou Lee, Donald Lloyd-Jones, Young Gyu Ko, Byoung Gwon Kim, Hyeon Chang Kim
BMJ Public Health.2024; 2(1): e000877. CrossRef
Material and social deprivation associated with public health actual causes of death among older people in Europe: longitudinal and multilevel results from the Survey of Health, Ageing and Retirement in Europe (SHARE)
Matthias Hans Belau
Frontiers in Public Health.2024;[Epub] CrossRef

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