Background and objectives Smoking is associated with vascular calcification and a higher risk of cardiovascular disease. In this study, we investigated the association of smoking dose and cessation with coronary artery calcification (CAC) in patients with CKD. Design, setting, participants, & measurements From a nationwide, prospective cohort of Korean patients with CKD, 1914 participants were included. Prevalent CAC was defined as an Agatston score.0, using computed tomography. CAC progression was defined as $30%/yr increase in Agatston score at the 4-year follow-up examination in patients with baseline CAC. Results Prevalent CAC was observed in 952 (50%) patients. Compared with never smokers, former smokers had a similar prevalence ratio for CAC, but current smokers had a 1.25-fold higher prevalence ratio (95% confidence interval [95% CI], 1.10 to 1.42). Among former smokers, a lower smoking load of,10 pack-years (prevalence ratio, 0.77; 95% CI, 0.65 to 0.90) and longer duration of smoking cessation (prevalence ratio for 10 to,20 years, 0.85; 95%CI, 0.73 to 0.98: prevalence ratio for$20 years, 0.83; 95%CI, 0.73 to 0.96)were associated with lower risk of prevalent CAC compared with current smoking. The prevalence ratios did not differ between never smoking and long-term cessation. However, short-term cessation with heavy smoking load was associatedwith a higher risk of prevalent CAC (prevalence ratio, 1.21; 95%CI, 1.03 to 1.40) comparedwith never smoking. CAC progression was observed in 111 (33%) patients with baseline CAC. Compared with never smokers, former smokers showed a similar risk of CAC progression, but current smokers had a higher risk (relative risk, 1.92; 95% CI, 1.30 to 2.86). Conclusions In CKD, former smoking with a lower smoking load and long-term cessation were associated with a lower risk of prevalent CAC than current smoking. CAC progression was more pronounced in current smokers.
|Number of pages||10|
|Journal||Clinical Journal of the American Society of Nephrology|
|Publication status||Published - 2021 Jun|
Bibliographical noteFunding Information:
S.H. Han reports serving as a subeditor of Nephrology and serving as a scientific advisor or member of the Korean Society of Nephrology. K.-H. Oh reports receiving research funding from Fresenius Medical Care, Korea. All remaining authors have nothing to disclose.
This study was supported by a research program of the Korea Centers for Disease Control and Prevention (grants 2011E3300300, 2012E3301100, 2013E3301600, 2013E3301601, 2013E3301602, 2016E3300200, 2016E3300201, 2016E3300202, 2019E320100, and 2019E320101).
© 2021 by the American Society of Nephrology.
All Science Journal Classification (ASJC) codes
- Critical Care and Intensive Care Medicine