Cumulative tobacco consumption has a dose-dependent effect on atheromatosis burden and improves severe atheromatosis prediction in asymptomatic middle-aged individuals: The ILERVAS study
Por:
Bermudez-Lopez, M, Marti-Antonio, M, Castro-Boque, E, Bretones, MD, Farras, C, Gonzalez, J, Pamplona, R, Lecube, A, Mauricio, D, Cambray, S, Valdivielso, JM, Fernandez, E
Publicada:
1 jun 2023
Ahead of Print:
1 jun 2023
Resumen:
Background and aims: Sex-specific impact of cumulative tobacco consumption (CTC) on atheromatosis extension and total plaque area remains unknown. We aimed to determine the impact of CTC in atheromatosis localization and burden.Methods: We performed a cross-sectional analysis in 8330 asymptomatic middle-aged individuals. 12-territory vascular ultrasounds in carotid and femoral arteries were performed to detect atheromatous plaque presence and to measure total plaque area. Adjusted regressions and conditional predictions by smoking habit or CTC (stratified in terciles as low (& LE;13.53), medium (13.54-29.3), and high (>29.3 packs-year)) were calculated. Severe atheromatosis (SA, & GE;3 territories with atheroma plaque) was predicted with the Systematic COronary Risk Evaluation 2 (SCORE2) model. The improvement of SA prediction after adding CTC was evaluated.Results: CTC was associated with an increased risk of atheromatosis, stronger in femoral than in carotid artery, but similar in both sexes. A dose-dependent effect of CTC on the number of territories with atheroma plaque and total plaque area was observed. Addition of CTC to the SCORE2 showed a higher sensitivity, accuracy, and negative predictive value in males, and a higher specificity and positive predictive value in females. In both sexes, the new SCORE2-CTC model showed a significant increase in AUC (males: 0.033, females: 0.038), and in the integrated discrimination index (males: 0.072; females: 0.058, p < 0.001). Age and CTC were the most important clinical predictors of SA in both sexes.Conclusions: CTC shows a dose-dependent association with atheromatosis burden, impacts more strongly in femoral arteries, and improves SA prediction.
Filiaciones:
Bermudez-Lopez, M:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Marti-Antonio, M:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Castro-Boque, E:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Bretones, MD:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Farras, C:
Inst Catala Salut, Ctr Atencio Primaria Cappont Gerencia Terr Lleida, Barcelona, Spain
Fundacio Inst Univ Recerca Atenc Primaria Salut J, Res Support Unit Lleida, Barcelona, Spain
Gonzalez, J:
Univ Lleida, Hosp Univ Arnau Vilanova, Dept Med Resp, Grup Recerca Translat Med Resp,IRBLleida, Lleida, Spain
CIBER Enfermedades Resp CIBERES, Madrid, Spain
Pamplona, R:
Univ Lleida, Dept Med Expt, IRBLleida, Lleida, Spain
Lecube, A:
Univ Lleida, Hosp Univ Arnau Vilanova, Dept Endocrinol & Nutr, Grup Recerca Obesitat & Metab ODIM,IRBLleida, Lleida, Spain
Inst Salud Carlos III ISCIII, Ctr Invest Biome Red Diabet & Enfermedades Metab, Madrid, Spain
Mauricio, D:
Inst Salud Carlos III ISCIII, Ctr Invest Biome Red Diabet & Enfermedades Metab, Madrid, Spain
Hosp Santa Creu & Sant Pau, Inst Recerca Biome St Pau IIB St Pau, Dept Endocrinol & Nutr, Barcelona, Spain
Univ Vic, Fac Med, Vic, Spain
Cent Univ Vic, Vic, Spain
Cambray, S:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Valdivielso, JM:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Fernandez, E:
Red Invest Renal RedInRen ISCIII, Grp Invest Translac Vasc & Renal, IRBLleida, Lleida, Spain
Bronze, All Open Access; Bronze
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