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September 17, 2026TomographyOpen Access

Association Between Cigarette Smoking and Carotid Plaque Stiffness Assessed Using Ultrasound Shear-Wave Elastography

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Why the study?

Is current cigarette smoking associated with increased carotid plaque stiffness assessed using 2D-SWE in patients with carotid plaques?

Population

93 patients with 132 carotid plaques who underwent carotid ultrasound 2D-SWE

Comparison

Current cigarette smoking vs Non-smokers

Design

Cohort

Key result

Cigarette smoking was associated with significantly greater carotid plaque stiffness compared to non-smokers (median shear-wave velocity 4.17 m/s vs 2.91 m/s; p<0.001).

Authors

SSSalahaden R. SultanAAAdel Alzahrani

Discussion

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Overview

May support 2D-SWE for smoking-related plaque assessment; hypothesis-generating and should not yet change practice.

Key Points

  • To assess whether carotid plaque stiffness measured via two-dimensional ultrasound shear-wave elastography is associated with cigarette smoking status.
  • Evaluated 132 carotid plaques from 93 patients (45 current smokers with 65 plaques; 48 non-smokers with 67 plaques) using carotid ultrasound 2D-SWE.
  • Quantified plaque stiffness via shear-wave velocity (m/s) using three measurements per plaque (396 measurements total) and compared clinical and demographic variables.
  • Plaques in smokers had significantly greater stiffness than those in non-smokers (median shear-wave velocity: 4.17 m/s, IQR 1.94 vs. 2.91 m/s, IQR 1.81; Z = −5.36, p < 0.001).
  • Smoking status was positively correlated with shear-wave velocity (r = 0.27, p < 0.001), while age, sex, hypertension, and diabetes mellitus did not differ significantly between groups.

Study Design

Type

Observational (n=93)

Structured PICO

Is current cigarette smoking associated with increased carotid plaque stiffness assessed using 2D-SWE in patients with carotid plaques?

P
Population
93 patients with 132 carotid plaques evaluated using 2D-SWE, classified as current cigarette smokers (n=45) and non-smokers (n=48).
E
Exposure
Current cigarette smoking
C
Comparator
Non-smokers
O
Outcome
Carotid plaque stiffness quantified using shear-wave velocity (m/s) measured by 2D-SWEsurrogate

Main Result

Absolute Event Rate: 4.17% vs 2.91%

p-value: p=<0.001

Cigarette smoking is associated with increased carotid plaque stiffness measured by 2D-SWE, highlighting its potential as a non-invasive marker for smoking-related plaque composition changes.

Limitations

  • Lack of data on smoking duration and cumulative exposure
  • Small sample size requiring larger studies to determine clinical significance
  • Small sample size

Cite This Study

Sultan et al. (2026) conducted an observational in Carotid plaques (n=93). Cigarette smoking vs. Non-smokers was evaluated on Carotid plaque stiffness (shear-wave velocity in m/s) (p=<0.001). Cigarette smoking was associated with significantly greater carotid plaque stiffness compared to non-smokers (median shear-wave velocity 4.17 m/s vs 2.91 m/s; p<0.001).

synapsesocial.com/papers/6aabb73d5f706d05830e6251https://doi.org/10.3390/tomography12090135
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