Abstract 10304: Influence of Smoking on the Prognostic Value of CTA
Introduction: Computed tomography coronary angiography (CTA) is an important non-invasive imaging modality increasingly used for the diagnosis and prognosis of coronary artery disease (CAD). The purpose of the current study was to determine the influence of smoking status on the prognostic value of CTA in patients with suspected or known CAD.
Methods: In 1207 patients (57% male, age 57±12 years) referred for CTA, the presence of significant CAD (≥50% stenosis) was determined. During follow-up the following events were recorded: all cause mortality, and non-fatal infarction. The prognostic value of CTA in smokers and non-smokers was compared using an interaction term in the Cox proportional hazard regression analysis.
Results: During a median follow-up time of 2.2 years, an event occurred in 50 patients. After correction for baseline characteristics including smoking in a multivariate model, CTA remained an independent predictor of events. Furthermore, a significant interaction (p<0.05) was observed between CTA and smoking. When assessing the survival in patients with significant CAD (n=327, 27%) the annualized event rate in smokers (n=98) was 8.78% compared to 2.07% in non-smokers (n=229). In patients without significant CAD (n=880, 73%) an annualized event rate of 0.99% was observed in smokers (n=175) compared to a similar 1.01% event rate in non-smokers (n=705).
Conclusions: The prognostic value of CTA was significantly influenced by smoking status. The event rates in patients with significant CAD were approximately 4-fold higher in smokers compared to non-smokers. These findings suggest that smoking cessation needs to be aggressively pursued in smokers with significant CAD.
- © 2010 by American Heart Association, Inc.