Cigarette smoking, coronary plaque burden and phenotype: a multimodality meta-analysis and implications for coronary artery calcium scoring in prevention
Authors' conclusion
Cigarette smoking is associated with greater coronary plaque burden and a relative excess of non-calcified plaque compared with never-smoking.
Study context
- Population
- Imaging studies of coronary plaque comparing smokers with never-smokers; mean age 58 years, 65% male
- Participants
- 251,839 participants · 16 studies
- Comparison
- Smokers vs never-smokers
- Outcome
- Plaque presence and specific plaque phenotypes
Methodological detailsrandom-effects, multimodality imaging (CCTA, IVUS, OCT)
- Random-effects
- Multimodality imaging (CCTA, IVUS, OCT)
Pooled result
As reported in the abstract
Coronary plaque presence and phenotype
Smokers vs Never-smokersOdds ratio (95% CI)
Any detectable coronary plaque
1.42(1.32–1.53)
Mixed plaque
1.52(1.31–1.78)
- Smoking and calcified plaque: OR
- 1.33 (95% CI 1.11-1.58)
Original publication
Cigarette smoking, coronary plaque burden and phenotype: a multimodality meta-analysis and implications for coronary artery calcium scoring in prevention. Eur J Prev Cardiol. Published 1 September 2026. doi:10.
Summarised from the published abstract; every number is checked against it