Evidence map›Paper›PMID 40074467›Full record

ArticleJournal of the American College of Cardiology2025

Association Between Cigarette Smoking and Subclinical Markers of Cardiovascular Harm.

Zhiqi Yao, Erfan Tasdighi, Zeina A Dardari, Kunal K Jha, Ngozi Osuji, Tanuja Rajan, Ellen Boakye, Carlos J Rodriguez, Kunihiro Matsushita, Eleanor M Simonsick and 25 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the American College of Cardiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed.

  1. Review
  2. Modeling the Exposome in Murine Cardiovascular Disease.JACC. Basic to translational science · 2026
    Review
  3. Review
  4. Review
  5. Article
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  11. Article
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  13. Article
  14. Review
  15. Article
  16. Article
  17. Hypertension as another Facet of Passive Smoking.Arquivos brasileiros de cardiologia · 2025
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

35 authors.

Zhiqi YaoCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Erfan TasdighiCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Zeina A DardariCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Kunal K JhaCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Ngozi OsujiCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Tanuja RajanCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA.
Ellen BoakyeCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA.
Carlos J RodriguezAmerican Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA; Division of Cardiovascular Medicine, Albert Einstein College of Medicine, Bronx, New York, USA.
Kunihiro MatsushitaDepartment of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Eleanor M SimonsickIntramural Research Program, National Institute on Aging, Baltimore, Maryland, USA.
Joao A C LimaDivision of Cardiology, Department of Medicine, Johns Hopkins University, Baltimore, Maryland, USA.
Rachel WidomeDivision of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA.
Debbie L CohenRenal-Electrolyte and Hypertension Division, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Lawrence J AppelDepartment of Epidemiology, Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.
Amit KheraDivision of Cardiology, UT Southwestern Medical Center, Dallas, Texas, USA.
Michael E HallAmerican Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA; Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA.
Suzanne E JuddDepartment of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Shelley A ColePopulation Health Program, Texas Biomedical Research Institute, San Antonio, Texas, USA.
Ramachandran S VasanUniversity of Texas School of Public Health San Antonio, San Antonio, Texas, USA.
Emelia J BenjaminAmerican Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA; Department of Epidemiology, School of Public Health, Boston University, Boston, Massachusetts, USA.
Paulo A LotufoCenter for Clinical and Epidemiological Research, Universidade de São Paulo, São Paulo, Brazil; Department of Internal Medicine, Universidade de São Paulo, São Paulo, Brazil.
Isabela M BenseñorDepartment of Internal Medicine, Universidade de São Paulo, São Paulo, Brazil.
Samar R El KhoudaryDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Emma Barinas-MitchellDepartment of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Imke JanssenDepartment of Family and Preventive Medicine, Rush University Rush Medical Center, Chicago, Illinois, USA.
Bruce M PsatyCardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
Charles B EatonCenter for Primary Care and Prevention, Department of Family Medicine and Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Michael J LaMonteDepartment of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA.
Peggy M CawthonCalifornia Pacific Medical Center Research Institute, San Francisco, California, USA.
Eric S OrwollDivision of Endocrinology, Diabetes and Clinical Nutrition, School of Medicine, Oregon Health & Science University, Portland, Oregon, USA.
Marguerite R IrvinDepartment of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Aruni BhatnagarAmerican Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA; University of Louisville School of Medicine, Louisville, Kentucky, USA.
Andrew P DeFilippisAmerican Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA; Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Omar El-ShahawayDepartment of Population Health, Grossman School of Medicine, New York University, New York, New York, USA; School of Global Public Health, New York University, New York, New York, USA.
Michael J BlahaCiccarone Center for Prevention of Cardiovascular Disease, Johns Hopkins Medicine, Baltimore, Maryland, USA; American Heart Association Tobacco Regulation and Addiction Center, Dallas, Texas, USA. Electronic address: mblaha1@jhmi.edu.

Funding

The Southwest National Primate Research Center Supplement- Infrastructure improvements of ABSL2 holding areasP51OD011133 · OD · TEXAS BIOMEDICAL RESEARCH INSTITUTE · PI Larry S. Schlesinger · 2012 to 2026
$129.7M
UCSF CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR024131 · NCRR · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JOHNSTON, S. CLAIBORNE · 2006 to 2011
$111.2M
VCID and Stroke in a Bi-racial National CohortU01NS041588 · NINDS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI CUSHMAN, MARY, HOWARD, GEORGE · 2002 to 2022
$96.0M
Oregon Clinical and Translational Research Institute - The National COVID Cohort Collaborative (N3C)UL1TR002369 · NCATS · OREGON HEALTH & SCIENCE UNIVERSITY · PI Cynthia D Morris, Christopher G. Slatore · 2017 to 2026
$78.4M
The Study of Women's Health Across the Nation (SWAN): The Impact of Midlife and the Menopause Transition on Health and Functioning in Early Old AgeU19AG063720 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REBECCA C THURSTON · 2020 to 2026
$61.3M
Institute for Clinical and Translational ResearchUL1TR001079 · NCATS · JOHNS HOPKINS UNIVERSITY · PI FORD, DANIEL ERNEST · 2013 to 2017
$60.1M
Scientific and Data Coordinating Center(SDCC) for the P*U01DK060990 · NIDDK · UNIVERSITY OF PENNSYLVANIA · PI FELDMAN, HAROLD I · 2001 to 2017
$50.1M
Clinical and Translational Science Collaborative of ClevelandUL1TR000439 · NCATS · CASE WESTERN RESERVE UNIVERSITY · PI KONSTAN, MICHAEL W. · 2012 to 2016
$50.0M
Michigan Institute for Clinical and Health Research (MCHR)UL1TR000433 · NCATS · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI MASHOUR, GEORGE ALEXANDER · 2012 to 2016
$49.9M
Institutional Clinical and Translational Science AwardUL1TR000003 · NCATS · UNIVERSITY OF PENNSYLVANIA · PI FITZGERALD, GARRET A · 2012 to 2015
$38.9M
WOMENS HEALTH ACROSS THE NATION--COORDINATING CENTERU01AG012553 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI BROOKS, MARIA MORI · 1994 to 2019
$37.7M
Wake Forest Clinical and Translational Science AwardUL1TR001420 · NCATS · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI ARD, JAMY D, FOLEY, KRISTIE L · 2015 to 2023
$32.3M
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6 · The paper itself

Abstract

backgroundCigarette smoking is a strong risk factor for cardiovascular harm.

objectivesThe study sought to explore the detailed relationships between smoking intensity, pack-years, and time since cessation with inflammation, thrombosis, and subclinical atherosclerosis markers of cardiovascular harm.

methodsWe included 182,364 participants (mean age 58.2 years, 69.0% female) from 22 cohorts of the Cross Cohort Collaboration with self-reported smoking status, including smoking intensity and/or pack-years, and concurrent subclinical marker measurements. Markers were categorized into 3 domains: inflammation (high-sensitivity C-reactive protein, interleukin-6, glycoprotein acetylation), thrombosis (fibrinogen, D-dimer), and subclinical atherosclerosis (coronary artery calcium, carotid intima-media thickness, carotid plaque, and ankle-brachial index). Utilizing multivariate regression models and restricted cubic splines, we assessed associations of smoking status, intensity, pack-years, time since cessation, and subclinical markers.

resultsA total of 15.3% of participants currently smoke (mean 16.7 cigarettes/day, mean 30.0 pack-years), and 34.6% of participants formerly smoked (median 19.0 years since quitting, mean 22.4 pack-years). Participants with a history of smoking showed higher levels of all subclinical markers compared with those who have never smoked, with stronger associations observed in those currently smoke. Among participants who currently smoke, smoking intensity showed a clear dose-response relationship with all markers, except for D-dimer, specifically with incremental 1% to 9% higher levels of subclinical markers per 10 cigarettes. After 20 cigarettes, the patterns appeared to plateau for blood markers, while they continued to increase for atherosclerosis markers. Among those who have ever smoked, robust dose-response relationships were observed for pack-years with all subclinical markers, with incremental 1% to 9% higher levels per 10 pack-years. The dose-response effects persisted after 20 pack-years for all markers, though with a milder slope. Among participants who smoked formerly, there were substantially lower levels of biomarkers with longer time since quitting, and most markers were not different compared with those who have never smoked by 30 years, except for the coronary artery calcium score, which remained 19% higher even beyond quitting after 30 years.

conclusionsSmoking-relevant parameters show strong and dose-response relationships across 3 domains of subclinical markers of cardiovascular harm. The sensitivity of the tested subclinical markers to small increments in cigarette exposure suggests potential value in the regulation of new and existing tobacco products.

Indexed as

Cardiovascular DiseasesCigarette SmokingAgedBiomarkersCarotid Intima-Media ThicknessFemaleFibrin Fibrinogen Degradation ProductsHumansMaleMiddle AgedBiomarkersFibrin Fibrinogen Degradation Productscardiovascular harmcigarette smokinginflammationsubclinical atherosclerosissubclinical markerthrombosis

Identifiers

PMID40074467
PMCPMC12812482

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.