Effect of Smoking on Coronary Artery Plaques in Type 2 Diabetes Mellitus: Evaluation With Coronary Computed Tomography Angiography

Background: The effect of smoking on coronary artery plaques examined by coronary computed tomography angiography (CCTA) in type 2 diabetes mellitus (DM) is not fully understood. To explore the effect of smoking on coronary artery plaque by comparing characteristics of plaques between diabetes with and without smoking history and among different smoking durations. Materials and methods: In total, 1058 DM patients found to have coronary plaques on CCTA were categorized into smoker (n=448) and nonsmoker group (n=610). Smoker was stratified by smoking duration (≤20 years [n=115], 20~40 years [n=233] and >40 years [n=100]). Plaque types, luminal stenosis (obstructive [40 years had more mixed plaques (OR=2.623 and 3.052; Ps40 years had more SIS≥4 (OR=1.900, P=0.034). Conclusion: Smoking is independently associated with presence of noncalcified, obstructive and more extensive coronary artery plaques in diabetes, and longer smoking duration is significantly associated with higher risk of mixed, obstructive and more extensive plaques