Prevention & lipidsMeta-analysis

Cigarette smoking, coronary plaque burden and phenotype: a multimodality meta-analysis and implications for coronary artery calcium scoring in prevention

Eur J Prev CardiolPublished

  • Systematic review and meta-analysis
  • random-effects
  • multimodality imaging (CCTA, IVUS, OCT)

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

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:10.1093/eurjpc/zwag453

Summarised from the published abstract; every number is checked against it