Abstract 16984: Associations of Cigarette Smoking With Cardiovascular Inflammation and Subclinical Atherosclerosis: The Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)
Introduction: Cigarette smoking is known to cause cardiovascular events, however there remains a need to identify sensitive biomarkers of early subclinical cardiovascular (CV) damage among smokers.
Hypothesis: We hypothesized that smoking status, burden, intensity, and time since quitting are associated with markers of subclinical inflammation and atherosclerosis.
Methods: The Brazilian Longitudinal Study of Adult Health is a prospective cohort that enrolled 14,103 asymptomatic civil servants at 6 cities. Baseline examination was conducted between 2008-2010. Participants self-reported current/past smoking habits. We evaluated baseline cross-sectional associations between smoking parameters and inflammation (high-sensitivity C-reactive protein [hsCRP]) and measures of subclinical atherosclerosis (carotid intima-media thickness [cIMT], ankle-brachial index [ABI] and coronary artery calcium [CAC]).
Results: The cohort included 1,844 current smokers, 4,121 former smokers and 8,138 never smokers. Mean age was 51.7±8.9 years; 45% were males. The strong associations of smoking status (current and former vs. never) and burden (cumulative pack-years) with each biomarker of injury are shown in Table 1. Among former smokers, hsCRP and cIMT levels were lower with increasing time (per 5 years) since quitting, β (95% CI)=-0.12 mg/L (-0.18 - -0.05), P=0.001 and β=-0.006 mm (-0.009 - -0.003), P<0.001, respectively, and the odds of ABI<1.0 and CAC>0 were also significantly lower, OR=0.84 (0.71 - 0.99), P=0.04 and 0.87 (0.81 - 0.94), P=0.001. Among current smokers, a positive association was found between smoking intensity (cigarettes/day) and CAC>0 (P=0.04) but not for other outcomes after adjusting for duration of smoking.
Conclusions: HsCRP, cIMT, ABI and CAC are sensitive biomarkers of subclinical CVD injury that may be abnormal in smokers with no clinically evident CVD. Our data help identify which biomarkers are most associated with tobacco smoking.
- Tobacco and electronic cigarettes
- Inflammation and inflammatory markers
- Carotid intima-media thickness (CIMT)
- Coronary artery calcification (CAC)
Author Disclosures: M.Y. Yakoob: None. S. Kianoush: None. M. Al-Rifai: None. A.P. Defilippis: Speakers Bureau; Modest; Astra Zeneca. Research Grant; Significant; Astra Zeneca. M.S. Bittencourt: None. B.B. Duncan: None. I.M. Bensenor: None. P.A. Lotufo: None. M.J. Blaha: None.
- © 2016 by American Heart Association, Inc.