Relation Between Cigarette Smoking and Heart Failure (from the Multiethnic Study of Atherosclerosis)

Megan Watson, Zeina Dardari, Sina Kianoush, Michael E. Hall, Andrew P. DeFilippis, Rachel J. Keith, Emelia J. Benjamin, Carlos J. Rodriguez, Aruni Bhatnagar, Joao A. Lima, Javed Butler, Michael J. Blaha, Mahmoud Al Rifai

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


We studied the association between cigarette smoking and incident heart failure (HF) in a racially diverse US cohort. We included 6,792 participants from the Multi-Ethnic Study of Atherosclerosis with information on cigarette smoking at baseline, characterized by status, intensity, burden, and time since quitting. Adjudicated outcomes included total incident HF cases and HF stratified by ejection fraction (EF) into HF with reduced EF (HFrEF; EF ≤ 40%) and preserved EF (HFpEF; EF ≥ 50%). We used Cox proportional hazards models adjusted for traditional cardiovascular risk factors and accounted for competing risk of each HF type. Mean age was 62 ± 10 years; 53% were women, 61% were nonwhite, and 13% were current smokers. A total of 279 incident HF cases occurred over a median follow-up of 12.2 years. The incidence rates of HFrEF and HFpEF were 2.2 and 1.9 cases per 1000 person-years, respectively. Current smoking was associated with higher risk of HF compared with never smoking (hazard ratio [HR], 2.05; 95% confidence interval [CI], 1.36 to 3.09); this was similar for HFrEF (HR, 2.58; 95% CI, 1.27 to 5.25) and HFpEF (HR, 2.51; 95% CI, 1.15 to 5.49). Former smoking was not significantly associated with HF (HR, 1.17; 95% CI, 0.88 to 1.56). Smoking intensity, burden, and time since quitting did not provide additional information for HF risk after accounting for smoking status.

Original languageEnglish (US)
Pages (from-to)1972-1977
Number of pages6
JournalAmerican Journal of Cardiology
Issue number12
StatePublished - Jun 15 2019

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


Dive into the research topics of 'Relation Between Cigarette Smoking and Heart Failure (from the Multiethnic Study of Atherosclerosis)'. Together they form a unique fingerprint.

Cite this