Smoking and sex differences in first manifestation of cardiovascular disease

Vasiljević, Zorana; Scarpone, Marialuisa; Bergami, Maria; Yoon, Jinsung; Schaar, Mihaela van der; Krljanać, Gordana; Ašanin, Milika; Davidović, Goran; Simović, Stefan; Manfrini, Olivia; Mickovski-Katalina, Natasa; Badimón, Lina; Cenko, Edina; Bugiardini, Raffaele

doi:10.1016/j.atherosclerosis.2021.06.909

Cited by 21 publications

(6 citation statements)

References 37 publications

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“…Centenarians have been found to possess lower inflammation measured by scores that include IL-6 as a main factor, potentially as a result of a counteracting anti-inflammaging response, and such findings have been associated with their better health ( Arai et al, 2015 ; Minciullo et al, 2016 ). Smoking behavior has been associated with the risk of cardiovascular disease development in a sex-dependent manner ( Vasiljevic et al, 2021 ), which has implications for the health of individuals. Cell-type differences predicted with DNAm have also been shown to differentiate amongst the oldest old in the Costa Rican Blue Zone, where a lower proportion of CD8 + memory T cells and higher proportion of naïve T cells were observed in Blue Zone residents compared to non-Blue Zone residents, indicating a younger immune system profile ( McEwen et al, 2017 ).…”

Section: Introductionmentioning

confidence: 99%

Sex differences in epigenetic age in Mediterranean high longevity regions

et al. 2022

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Sex differences in aging manifest in disparities in disease prevalence, physical health, and lifespan, where women tend to have greater longevity relative to men. However, in the Mediterranean Blue Zones of Sardinia (Italy) and Ikaria (Greece) are regions of centenarian abundance, male-female centenarian ratios are approximately one, diverging from the typical trend and making these useful regions in which to study sex differences of the oldest old. Additionally, these regions can be investigated as examples of healthy aging relative to other populations. DNA methylation (DNAm)-based predictors have been developed to assess various health biomarkers, including biological age, Pace of Aging, serum interleukin-6 (IL-6), and telomere length. Epigenetic clocks are biological age predictors whose deviation from chronological age has been indicative of relative health differences between individuals, making these useful tools for interrogating these differences in aging. We assessed sex differences between the Horvath, Hannum, GrimAge, PhenoAge, Skin and Blood, and Pace of Aging predictors from individuals in two Mediterranean Blue Zones and found that men displayed positive epigenetic age acceleration (EAA) compared to women according to all clocks, with significantly greater rates according to GrimAge (β = 3.55; p = 1.22 × 10−12), Horvath (β = 1.07; p = 0.00378) and the Pace of Aging (β = 0.0344; p = 1.77 × 10−08). Other DNAm-based biomarkers findings indicated that men had lower DNAm-predicted serum IL-6 scores (β = -0.00301, p = 2.84 × 10−12), while women displayed higher DNAm-predicted proportions of regulatory T cells than men from the Blue Zone (p = 0.0150, 95% Confidence Interval [0.00131, 0.0117], Cohen’s d = 0.517). All clocks showed better correlations with chronological age in women from the Blue Zones than men, but all clocks showed large mean absolute errors (MAE >30 years) in both sexes, except for PhenoAge (MAE <5 years). Thus, despite their equal survival to older ages in these Mediterranean Blue Zones, men in these regions remain biologically older by most measured DNAm-derived metrics than women, with the exception of the IL-6 score and proportion of regulatory T cells.

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Section: Introductionmentioning

confidence: 99%

Sex differences in epigenetic age in Mediterranean high longevity regions

et al. 2022

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“…For instance, women who were current smokers would take about 2.4 months whereas men would take about 3.5 months. The impact of smoking as a risk factor for CAD may be more detrimental in postmenopausal women because of the lack of natural estrogen protection, an unfavorable lipid profile, or in subjects at risk of thrombosis such as women taking oral contraceptives ( 30 , 31 ). This finding is relevant to make the population aware of the impact of smoking on health.…”

Section: Discussionmentioning

confidence: 99%

No Paradoxical Effect of Smoking Status on Recurrent Cardiovascular Events in Patients Following Percutaneous Coronary Intervention: Thai PCI Registry

Limpijankit

Chandavimol

Srimahachota

et al. 2022

Front. Cardiovasc. Med.

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Background“Smoker's paradox” is a controversial phenomenon that describes an unexpectedly favorable short-term outcome of smokers post-percutaneous coronary intervention (PCI). This study aimed to evaluate the effect of smoking status on recurrent major adverse cardiovascular events (MACEs) in patients who recently underwent PCI and to determine whether it was paradoxical.MethodsThis study utilized data from the nationwide Thai PCI registry, enrolling patients during 2018–2019. Our study factor was smoking status, classified as current smokers, ex-smokers, and nonsmokers. The outcome of interest was the time to occurrence of a composite of MACEs (i.e., all-cause death, myocardial infarction (MI), stroke, and unplanned revascularization) evaluated at about 1-year post-PCI. A propensity score (PS) model using inverse probability weighting with regression adjustment was used to estimate the effect of smoking on the occurrence of MACE.ResultsCurrent smokers, ex-smokers, and non-smokers accounted for 23, 32, and 45% of the 22,741 subjects, respectively. Smokers were younger, more frequently male, and had fewer traditional atherosclerotic risk factors. Current smokers presented more frequently with ST-elevation MIs (STEMIs) and cardiogenic shock (54 and 14.6%, respectively) than non-smokers. MACE rates were 1.9, 1.2, and 1.6 per 100 patients per month in the current smokers, ex-smokers, and non-smokers, respectively. After applying a PS, patients with a history of current smoking and ex-smoking developed the onset of recurrent MACEs significantly sooner than non-smokers, with a median time of 4.4 vs. 4.9 vs. 13.5 months (p < 0.001), respectively.Conclusions“Smoker's paradox” was not observed in our patient population. Current smokers and ex-smokers were prone to develop an earlier onset of a post-PCI MACEs than nonsmokers and need a smoke cessation program for further prevention.

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“… 32 The greater susceptibility to smoking‐related endothelial dysfunction in women might explain. 33 The associations between female smoking and plaque formation showed greater heterogeneity, which may be due to the small sample size of women who were smoking at baseline and without plaques. The association between alcohol consumption and atherosclerosis is controversial.…”

Section: Discussionmentioning

confidence: 99%

“…A prospective study based on UK Biobank participants also found that smoking was related to higher risk for myocardial infarction in women 32 . The greater susceptibility to smoking‐related endothelial dysfunction in women might explain 33 . The associations between female smoking and plaque formation showed greater heterogeneity, which may be due to the small sample size of women who were smoking at baseline and without plaques.…”

Section: Discussionmentioning

confidence: 99%

Sex‐specific risk factors of carotid atherosclerosis progression in a high‐risk population of cardiovascular disease

Cheng

Zhou

Wang

et al. 2022

Clinical Cardiology

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Background The progression of carotid intima‐media thickness (cIMT) and plaques are associated with cardiovascular health, especially for high‐risk population of cardiovascular disease (CVD). Hypothesis Risk factors for atherosclerosis may vary by sex. This study aimed to investigate the sex‐specific risk factors of cIMT and plaque progression. Methods We selected subjects who were identified as high‐risk population of CVD, and collected their carotid ultrasound data and baseline characteristics. Linear regression and logistic regression analyses were used to identify risk factors for cIMT and plaque progression. Sex‐specific risk factors were identified respectively. Results A total of 7908 participants were included. The mean age was 57.75 ± 9.45 years and 61.51% were female. During mean follow‐up of 1.92 ± 0.89 years, the median annual cIMT change rate was −7.25 μm/year. Seven hundred and fifteen subjects free from plaques at baseline developed plaque. Age, smoking, hypertension, and diabetes were common risk factors for carotid atherosclerosis progression in all participants. Smoking and alcohol drinking were significantly associated with increased cIMT change in women, while hypertension and antihypertensive medication were significant in men. Increased total cholesterol and diabetes were significantly associated with new plaque presence in women, while smoking, increased triglyceride, and dyslipidemia were significant in men ( p ˂ .05 for all cases). The association of baseline cIMT and smoking with annual cIMT change rate and increased total cholesterol with new plaque presence were significantly differentiated between both sexes ( p for interaction ˂ .05). Conclusions The risk factors for cIMT and plaque progression differed by sex.

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Smoking and sex differences in first manifestation of cardiovascular disease

Cited by 21 publications

References 37 publications

Sex differences in epigenetic age in Mediterranean high longevity regions

Sex differences in epigenetic age in Mediterranean high longevity regions

No Paradoxical Effect of Smoking Status on Recurrent Cardiovascular Events in Patients Following Percutaneous Coronary Intervention: Thai PCI Registry

Sex‐specific risk factors of carotid atherosclerosis progression in a high‐risk population of cardiovascular disease

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