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PLoS One. 2013 Jun 20;8(6):e66484. doi: 10.1371/journal.pone.0066484. Print 2013.

Impact of cardiovascular calcifications on the detrimental effect of continued smoking on cardiovascular risk in male lung cancer screening participants.

Author information

  • 1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands. pjairam@umcutrecht.nl

Abstract

BACKGROUND:

Current smokers have an increased cardiovascular disease (CVD) risk compared to ex-smokers due to reversible as well as irreversible effects of smoking. We investigated if current smokers remain to have an increased CVD risk compared to ex-smokers in subjects with a long and intense smoking history. We in addition studied if the effect of smoking continuation on CVD risk is independent of or modified by the presence of cardiovascular calcifications.

METHODS:

The cohort used comprised a sample of 3559 male lung cancer screening trial participants. We conducted a case-cohort study using all CVD cases and a random sample of 10% (nā€Š=ā€Š341) from the baseline cohort (subcohort). A weighted Cox proportional hazards model was used to estimate the hazard ratios for current smoking status in relation to CVD events.

RESULTS:

During a median follow-up of 2.6 years (max. 3.7 years), 263 fatal and non-fatal cardiovascular events (cases) were identified. Age, packyears and cardiovascular calcification adjusted hazard ratio of current smokers compared to former smokers was 1.33 (95% confidence interval 1.00-1.77). In additional analyses that incorporated multiplicative interaction terms, neither coronary nor aortic calcifications modified the association between smoking status and cardiovascular risk (Pā€Š=ā€Š0.08).

CONCLUSIONS:

Current smokers have an increased CVD risk compared to former smokers even in subjects with a long and intense smoking history. Smoking exerts its hazardous effects on CVD risk by pathways partly independent of cardiovascular calcifications.

PMID:
23840486
[PubMed - indexed for MEDLINE]
PMCID:
PMC3688769
Free PMC Article
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