Prevention & lipidsCohort study
Association Between Cigarette Smoking and Subclinical Markers of Cardiovascular Harm
- Pooled cohort analysis
- 22 cohorts
- multivariate regression with restricted cubic splines
Authors' conclusion
Smoking-relevant parameters show strong and dose-response relationships across 3 domains of subclinical markers of cardiovascular harm.
Study context
- Population
- Participants of 22 cohorts of the Cross Cohort Collaboration with self-reported smoking status and concurrent subclinical marker measurements (mean age 58.2 years, 69.0% female)
- Participants
- 182,364 participants · 22 cohorts
- Exposure
- Current and former smoking vs never smoking
- Outcome
- Subclinical markers of CV harm: inflammation (hs-CRP, IL-6, glycoprotein acetylation), thrombosis (fibrinogen, D-dimer), subclinical atherosclerosis (CAC, carotid intima-media thickness, carotid plaque, ankle-brachial index)
Main finding
As reported in the abstract
Subclinical markers by smoking status and exposure
- Current smoking: dose-response with all markers except D-dimer; higher levels per 10 cigarettes
- 1% to 9%
- Ever smoked: dose-response with all markers; higher levels per 10 pack-years (persisting after 20 pack-years, milder slope)
- 1% to 9%
- Former smoking: lower levels with longer time since quitting; most markers not different from never smoked by 30 years; CAC score remained higher beyond 30 years
- 19%
Observational data: associations, not effects.
Original publication
Association Between Cigarette Smoking and Subclinical Markers of Cardiovascular Harm. J Am Coll Cardiol. Published 18 March 2025. doi:10.1016/j.jacc.2024.12.032
Summarised from the published abstract; every number is checked against it