Both current and former smokers show lower coronary volume-to-myocardial mass ratio (V/M) on CT fractional flow reserve (CT-FFR), researchers have found.
In a study published March 14 in Radiology: Cardiothoracic Imaging, a team led by Kenneth Holmes, MD, of St Paul's Hospital and University of British Columbia in Vancouver, Canada, reported that smoking was associated with lower coronary volume-to-myocardial mass ratio in individuals with coronary artery disease (CAD) -- results that further cement the link between smoking and heart disease.
"[We found that] current and former smoking were independently associated with lower [V/M] in participants with coronary artery disease," the group noted.
Previous work has found low volume-to-myocardial mass ratio to be associated with conditions such as microvascular angina and hypertrophic cardiomyopathy, and in coronary artery disease, with greater stenosis, Holmes and colleagues noted. But the effect smoking has on volume-to-myocardial mass ratio has not been thoroughly established. The investigators addressed this knowledge gap through a study that included 2,874 patients from the Assessing Diagnostic Value of Noninvasive FFR-CT in Coronary Care (ADVANCE) registry who were evaluated for suspected coronary artery disease between July 2015 and October 2017 and found to have coronary stenosis of 30% or greater on coronary CT angiography (CCTA).
Patients were included if their smoking status was known and if they had undergone CT-FFR and coronary volume-to-myocardial mass ratio analysis; the researchers segmented the CCTA images to calculate coronary volume and myocardial mass ratio and compared it among smoking groups. Of the total cohort, 503 were current smokers, 1,060 were former smokers, and 1,311 were people who had never smoked.
Holmes's team found that both current and former smokers had lower coronary volume and myocardial mass than never-smokers.
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It also reported that the following factors were independent predictors of low coronary volume and myocardial mass:
- Current smoking status (odds ratio [OR], 0.74; p = 0.009)
- Former smoking status (OR, 0.81; p = 0.02)
- Stenosis of 50% or greater (OR, 0.62; p < 0.001)
- Diabetes (OR, 0.67; p < 0.001)
"In conclusion, history of smoking (current or former smoking status) was an independent predictor of low V/M derived from CT-FFR," the team wrote. "Mechanisms driving low V/M in smokers and the potential use of V/M as a surrogate marker of vascular health and predictor of downstream clinical outcomes require further study.
The complete research can be found here.
