The effect of cigarette smoking on the pattern of coronary atherosclerosis: A case-control study

R. Vander Zwaag, G. F. Lemp, J. P. Hughes, K Ramanathan, J. M. Sullivan, E. C. Schick, D. M. Mirvis

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Cigarette smoking is a risk factor for development of coronary atherosclerosis. We examined the relationship between smoking and the anatomic location of coronary artery stenosis in 8,705 patients undergoing cardiac catheterization for suspected coronary artery disease (CAD). The smoking history of patients with CAD (≥70 percent stenosis) was compared with that of control subjects (0 percent stenosis) for each of nine anatomic locations (proximal, middle, and distal segments of right [RCA], anterior descending [LAD], and circumflex arteries [LCX]), using a case-control method. The odds ratio (OR) estimate of relative risk of CAD for smokers relative to nonsmokers was 2.8, with a 95 percent confidence interval (CI) of 2.5 to 3.1. Relative risk was greater for RCA stenosis (OR = 5.8; CI = 4.6-7.2) than for LCX (OR = 3.5; CI = 2.7-4.5) or LAD (OR = 2.1; CI = 1.8-2.4) lesions when comparing smokers with nonsmokers. After control for age, gender, history of diabetes mellitus, and serum cholesterol level, the adjusted relative risk for an RCA lesion (Mantel-Haenszel odds ratio [MOR] = 4.9) was significantly elevated (p < 0.05) compared with the LAD (MOR = 1.9) but not with the LCX (MOR = 3.1). The relative risk of CAD were the same (p > 0.05) for the proximal, middle, and distal coronary segments. Thus, smoking increased the risk of all coronary lesions but did so more for the RCA than for other vessels, suggesting a spatial pattern to the increased risk produced by smoking.

Original languageEnglish (US)
Pages (from-to)290-295
Number of pages6
JournalChest
Volume94
Issue number2
StatePublished - Jan 1 1988
Externally publishedYes

Fingerprint

Case-Control Studies
Coronary Artery Disease
Smoking
Odds Ratio
Confidence Intervals
Pathologic Constriction
Arteries
Coronary Stenosis
Cardiac Catheterization
Diabetes Mellitus
History
Cholesterol
Serum

All Science Journal Classification (ASJC) codes

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Vander Zwaag, R., Lemp, G. F., Hughes, J. P., Ramanathan, K., Sullivan, J. M., Schick, E. C., & Mirvis, D. M. (1988). The effect of cigarette smoking on the pattern of coronary atherosclerosis: A case-control study. Chest, 94(2), 290-295.

The effect of cigarette smoking on the pattern of coronary atherosclerosis : A case-control study. / Vander Zwaag, R.; Lemp, G. F.; Hughes, J. P.; Ramanathan, K; Sullivan, J. M.; Schick, E. C.; Mirvis, D. M.

In: Chest, Vol. 94, No. 2, 01.01.1988, p. 290-295.

Research output: Contribution to journalArticle

Vander Zwaag, R, Lemp, GF, Hughes, JP, Ramanathan, K, Sullivan, JM, Schick, EC & Mirvis, DM 1988, 'The effect of cigarette smoking on the pattern of coronary atherosclerosis: A case-control study', Chest, vol. 94, no. 2, pp. 290-295.
Vander Zwaag R, Lemp GF, Hughes JP, Ramanathan K, Sullivan JM, Schick EC et al. The effect of cigarette smoking on the pattern of coronary atherosclerosis: A case-control study. Chest. 1988 Jan 1;94(2):290-295.
Vander Zwaag, R. ; Lemp, G. F. ; Hughes, J. P. ; Ramanathan, K ; Sullivan, J. M. ; Schick, E. C. ; Mirvis, D. M. / The effect of cigarette smoking on the pattern of coronary atherosclerosis : A case-control study. In: Chest. 1988 ; Vol. 94, No. 2. pp. 290-295.
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N2 - Cigarette smoking is a risk factor for development of coronary atherosclerosis. We examined the relationship between smoking and the anatomic location of coronary artery stenosis in 8,705 patients undergoing cardiac catheterization for suspected coronary artery disease (CAD). The smoking history of patients with CAD (≥70 percent stenosis) was compared with that of control subjects (0 percent stenosis) for each of nine anatomic locations (proximal, middle, and distal segments of right [RCA], anterior descending [LAD], and circumflex arteries [LCX]), using a case-control method. The odds ratio (OR) estimate of relative risk of CAD for smokers relative to nonsmokers was 2.8, with a 95 percent confidence interval (CI) of 2.5 to 3.1. Relative risk was greater for RCA stenosis (OR = 5.8; CI = 4.6-7.2) than for LCX (OR = 3.5; CI = 2.7-4.5) or LAD (OR = 2.1; CI = 1.8-2.4) lesions when comparing smokers with nonsmokers. After control for age, gender, history of diabetes mellitus, and serum cholesterol level, the adjusted relative risk for an RCA lesion (Mantel-Haenszel odds ratio [MOR] = 4.9) was significantly elevated (p < 0.05) compared with the LAD (MOR = 1.9) but not with the LCX (MOR = 3.1). The relative risk of CAD were the same (p > 0.05) for the proximal, middle, and distal coronary segments. Thus, smoking increased the risk of all coronary lesions but did so more for the RCA than for other vessels, suggesting a spatial pattern to the increased risk produced by smoking.

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