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Cui B, He K, Zhang X, Zhou W, Sun Z, Zhang M, Shi Y, Lei Y, Yao L, Li Y, Liao M, Song Y, Zhao X, Han H, Zhu Y, Guo M, Zhang H, Yang T, Miao Y, Bai T, Li M, Zhang W, Yao X, Kou X, Zhu Y, Yan H. Association of cigarette smoking with retinal thickness and vascular structure in an elderly Chinese population. Photodiagnosis Photodyn Ther 2021; 36:102481. [PMID: 34403826 DOI: 10.1016/j.pdpdt.2021.102481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/20/2021] [Accepted: 08/09/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND To explore the association of cigarette smoking with retinal thickness and vascular structure in an elderly Chinese population. METHODS This cross-sectional study enrolled employees and retirees aged over 50 years at Tianjin University of Sport from October 2020 to December 2020. Information on smoking status and lifestyle was obtained using a detailed questionnaire. All participants underwent full ophthalmic examination. OCTA image was acquired. Vascular and the thickness parameters in central fovea and peripapillary parameters were automatically calculated. Multiple linear regression analyses were utilized to assess the association of smoking with retinal thickness and vascular structure after controlling potential confounders. RESULTS Compared with non-smoking adults, current smokers (β=-36.78; P = 0.01) and ever smokers (β=-35.45; P = 0.00) tended to have thinner macular fovea. Cigarettes daily, pack-years of smoking and CSI were negatively related to macular thickness (cigarettes daily: β=-1.43; pack-years: β=-14.73; CSI: β=-14.70), while they were positively associated with the circumference (cigarettes daily: β=0.03; pack-years: β=0.30; CSI: β=0.31) and the area of FAZ (cigarettes daily: β=0.01; pack-years: β=0.07). CONCLUSIONS Cigarette smoking seems associated with decreased macular fovea thickness and elevated circumference and area of the FAZ compared to non-smokers. Our data add to evidence of smoking on retinal thickness and the microvascular system in the macular area.
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Affiliation(s)
- Bohao Cui
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Kai He
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiaodan Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Zhou
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Zhiyong Sun
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mingxue Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ying Shi
- Laboratory of Molecular Ophthalmology, Tianjin Medical University, Tianjin, China
| | - Yi Lei
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ling Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yiming Li
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengyu Liao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yinting Song
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao Zhao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Han Han
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yanfang Zhu
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Miao Guo
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Haokun Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tiantian Yang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yuyang Miao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Tinghui Bai
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Mengxuan Li
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Wei Zhang
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xueming Yao
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xuejing Kou
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China
| | - Yun Zhu
- Department of Epidemiology and Biostatistics, School of Public Health Tianjin Medical University, Tianjin, China.
| | - Hua Yan
- Department of Ophthalmology, Tianjin Medical University General Hospital, Tianjin, China.
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McEvoy JW, Blaha MJ, DeFilippis AP, Lima JAC, Bluemke DA, Hundley WG, Min JK, Shaw LJ, Lloyd-Jones DM, Barr RG, Budoff MJ, Blumenthal RS, Nasir K. Cigarette smoking and cardiovascular events: role of inflammation and subclinical atherosclerosis from the MultiEthnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol 2015; 35:700-9. [PMID: 25573855 DOI: 10.1161/atvbaha.114.304562] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVES To examine the contemporary effect of smoking in a multiethnic sample, and to explore the respective contributions of inflammation and subclinical atherosclerosis to the cardiovascular consequences of smoking. APPROACH AND RESULTS We studied 6814 participants free of cardiovascular disease and coronary heart disease (CHD) from the Multiethnic Study of Atherosclerosis. Smoking status and cumulative exposure were determined by self-report and confirmed by urinary cotinine. Multivariable Cox regression was used to estimate the association between smoking parameters and all-cause cardiovascular disease, all-cause CHD, and hard CHD events. We further adjusted for high-sensitivity C-reactive protein and coronary artery calcium (CAC) in hierarchical Cox models. We identified 3218 never smokers, 2607 former smokers, and 971 current smokers. Median follow-up was 10.2 years. Compared with never smokers, adjusted hazard ratios in current smokers were 1.7 (95% confidence interval, 1.3-2.2) for all-cause cardiovascular disease, 1.6 (1.1-2.1) for all-cause CHD, and 1.7 (1.2-2.4) for hard CHD. Similarly, among current smokers, hazard ratios were higher in the 4th versus 1st quartile of pack-years (eg, all-cause CHD hazard ratio=2.7 [1.1-6.6]). Both CAC>100 and high-sensitivity C-reactive protein ≥3 mg/L identified higher relative risk among current smokers (eg, all-cause CHD hazard ratio of 3.0 [1.5-6.0, compared with CAC=0] and 2.6 [1.4-4.8, compared with high-sensitivity C-reactive protein <2 mg/L], respectively). However, CAC was a stronger mediator of events and adversely modified the effect of smoking on events (eg, P-interaction=0.02 for hard CHD). Compared with never smokers, former smokers (median cessation interval=22 years) had similar adjusted hazard for events. CONCLUSIONS In this multiethnic cohort, current smoking and cumulative exposure remain important modifiable determinants of cardiovascular disease. Both high-sensitivity C-reactive protein ≥3 mg/L and, particularly, CAC>100 identified high-risk smokers who may benefit from more intensive smoking-cessation efforts.
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Affiliation(s)
- John W McEvoy
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Michael J Blaha
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Andrew P DeFilippis
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Joao A C Lima
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - David A Bluemke
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - W Gregory Hundley
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - James K Min
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Leslee J Shaw
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Donald M Lloyd-Jones
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - R Graham Barr
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Matthew J Budoff
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Roger S Blumenthal
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.)
| | - Khurram Nasir
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., M.J. Blaha, A.P.D., R.S.B., K.N.) and Division of Cardiology (J.A.C.L.), Johns Hopkins University, Baltimore, MD; Division of Cardiology, Rudd Heart and Lung Center, University of Louisville, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of Cardiology, Cedars Sinai Medical Center, Heart Institute, Los Angeles, CA (J.K.M.); Division of Cardiology, Emory University School of Medicine, Atlanta, GA (L.J.S.); Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL (D.M.L.-J.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA (M.J. Budoff); Center for Wellness and Prevention, and Miami Cardiovascular Institute (MCVI), Baptist Health South Florida, Miami (K.N.); and Department of Medicine, Herbert Wertheim College of Medicine, and Department of Epidemiology, Robert Stempel College of Public Health, Florida International University, Miami (K.N.).
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