Researchers found that both current and former smokers had lower coronary artery volume-to-myocardial mass ratio (V/M) on CT fractional flow reserve (CT-FFR).

In a study published on March 14, Radiology: Cardiothoracic imagingA team led by Dr. Kenneth Holmes at St. Paul’s Hospital in Vancouver, Canada, and the University of British Columbia reported that smoking is associated with a lower coronary artery volume-to-myocardial mass ratio in patients with coronary artery disease (CAD). The findings further solidify the link between smoking and heart disease.

”[We found that] Current smoking and previous smoking were independently associated with decline [V/M] “It is more common in participants with coronary artery disease,” the group said.

Previous studies have found that a low volume-to-myocardial mass ratio is associated with conditions such as microvascular angina and hypertrophic cardiomyopathy, as well as coronary artery disease with greater stenosis. pointed out Holmes et al. However, the effect of smoking on myocardial volume to myocardial mass ratio is not fully established. Researchers evaluated the diagnostic value of non-invasive FFR-CT in coronary artery disease, where patients were evaluated for suspected coronary artery disease and found to have coronary artery stenosis between July 2015 and October 2017. We addressed this knowledge gap through a study of 2,874 patients from the (ADVANCE) registry. 30% or more on coronary CT angiography (CCTA).

Patients with known smoking status and undergoing CT-FFR and coronary artery volume-to-myocardial mass ratio analysis were included. The researchers segmented CCTA images to calculate coronary artery volume and myocardial mass ratio, which they compared between smoking groups. Of the total cohort, 503 were current smokers, 1,060 were former smokers, and 1,311 were never smokers.

Holmes’ team found that both current and former smokers had lower coronary artery volumes and myocardial mass than nonsmokers.

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We also reported that the following factors were independent predictors of decreased coronary artery volume and myocardial mass:

• Current smoking status (odds ratio) [OR]0.74; p = 0.009)
• Previous smoking status (OR, 0.81; p = 0.02)
• Stenosis ≥50% (OR, 0.62; p < 0.001)
• Diabetes (OR, 0.67; p < 0.001)

“In conclusion, smoking history (current or former smoking status) was an independent predictor of low V/M obtained from CT-FFR,” the research team wrote. “Further research is needed into the mechanisms leading to lower V/M in smokers and the potential use of V/M as a surrogate marker of vascular health and a predictor of downstream clinical outcomes.

The full survey results can be viewed here.