What is the clinical evidence from this study?

Study design: Systematic Review. Population: Coronary artery disease (n=6037). Intervention: Cigarette smoking. Primary outcome: Number of occluded coronary arteries and the severity and pattern of CAD.

December 1, 2021Open Access

Effect of cigarette smoking on coronary arteries and pattern and severity of coronary artery disease: a review

NSNahid SalehiKermanshah University of Medical Sciences PJParisa JanjaniKermanshah University of Medical Sciences HTHooman TadbiriUniversity of Maryland, Baltimore

Key Result

In a review of 11 studies (N=6,037), cigarette smoking was associated with CAD severity, but not with the number of damaged arteries.

Study Design

Type

Systematic Review (n=6,037)

Structured PICO

Does cigarette smoking influence the severity, pattern, and number of occluded coronary arteries in patients with CAD?

Population

11 observational studies including 6,037 individuals assessing the effect of smoking on the pattern and severity of coronary artery disease.

Exposure

Cigarette smoking

Outcome

Number of occluded coronary arteries and the severity and pattern of CADsurrogate

This systematic review suggests that while smoking is associated with CAD severity, it may not significantly correlate with the absolute number of damaged coronary arteries.

Abstract

OBJECTIVE: Smoking is a risk factor for coronary artery disease (CAD) and a known factor influencing the severity and pattern of CAD. We summarized evidence regarding the effect of smoking on the number of occluded coronary arteries and the severity and pattern of CAD. METHODS: We extracted data from observational studies reporting the pattern and severity of CAD in smokers. The quality of studies was assessed using the Strengthening the Reporting of Observational Studies in Epidemiology checklist, and results are reported in the Garrard table. The review process followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. RESULTS: We screened 11 studies including 6037 samples. Six studies reported no relationship between smoking and the number of damaged arteries. One study reported that smoking was related to occlusion in the left anterior descending artery, but there was no relationship between smoking and the location of occlusion in the arteries. Smoking was related to CAD severity in five studies. CONCLUSIONS: Smoking was found to be related to CAD severity and location of the damaged artery in the heart. However, there was no significant association of smoking with the number of damaged arteries and location of arterial occlusion.

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