Smoking cessation and coronary artery calcification in CKD

Mi Jung Lee, Jung Tak Park, Tae Ik Chang, Young Su Joo, Tae Hyun Yoo, Sue Kyung Park, Wookyung Chung, Yong Soo Kim, Soo Wan Kim, Kook Hwan Oh, Shin Wook Kang, Kyu Hun Choi, Curie Ahn, Seung Hyeok Han

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish
Pages (from-to)870-879
Number of pages10
JournalClinical Journal of the American Society of Nephrology
Volume16
Issue number6
DOIs
Publication statusPublished - 2021 Jun

Bibliographical note

Funding 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.

Funding Information:
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).

Publisher Copyright:
© 2021 by the American Society of Nephrology.

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Critical Care and Intensive Care Medicine
  • Nephrology
  • Transplantation

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