Author + information
- Received July 13, 1982
- Revision received August 9, 1982
- Accepted August 19, 1982
- Published online February 1, 1983.
- Lloyd W. Klein, MD*,
- Augusto D. Pichard, MD, FACC,
- James Holt, MA,
- Harry Smith, PhD,
- Richard Gorlin, MD, FACC and
- Louis E. Teichholz, MD, FACC
- ↵*Address for reprints: Lloyd W. Klein, MD, Division of Cardiology, Mount Sinai Medical Center, 1 Gustave L. Levy Place, New York, New York 10029.
The effects of chronic smoking on the coronary circulation were studied by evaluating the coronary vascular reserve in 12 chronic smokers (group 1) and 10 non-smokers (group 2). All patients were referred to cardiac catheterization for evaluation of chest pain and were found to have normal coronary and left ventricular angiograms. Coronary vascular reserve was measured by analyzing the hyperemic response to selective coronary injection of contrast agent. There was no statistically significant difference between groups 1 and 2 with regard to age, baseline electrocardiogram or response to treadmill or thallium-201 exercise tests.
The mean coronary reserve (± standard deviation) was 74.1 ± 20.1% in the smokers versus 117.1 ± 45.1% in the nonsmokers (p < 0.02). In patients who smoked 1 pack a day or less and in those who smoked more than 1 pack a day, the mean coronary reserve was 89.5 and 64.9%, respectively (p < 0.05). Additionally, of 20 patients followed up for an average of 20 months, 7 of 10 smokers and 1 of 10 nonsmokers continued to have chest pain (p < 0.03). The cause for the chest pain has not been established in these patients. These results suggest that coronary vascular reserve is significantly less in chronic smokers than in nonsmokers, and that this decrease is more pronounced in heavy smokers.
- Received July 13, 1982.
- Revision received August 9, 1982.
- Accepted August 19, 1982.
- American College of Cardiology Foundation