Smoking as a Global Threat to the Cardiovascular System: Innovative Approaches to Risk Stratification and Lifestyle Modification Based on Data from the 2026 European Congress of Cardiology

Vlasenko O.V.

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Smoking as a Global Threat to the Cardiovascular System: Innovative Approaches to Risk Stratification and Lifestyle Modification Based on Data from the 2026 European Congress of Cardiology

October 14, 2026

Vlasenko O.V.

УДК: УДК 616.1:613.84:616.07

DOI: 10.32471/umj.1680-3051.281527

Keywords :

acute coronary syndrome,

atherosclerosis,

cardiovascular risk,

GLP-1 receptor agonists,

harm reduction,

non-HDL cholesterol,

SCORE-2,

secondary prevention,

smoking,

vascular aging

Resume

This article presents a systematic analysis of materials from the 2026 European Congress of Cardiology regarding the detrimental impact of tobacco smoking on the cardiovascular system and the implementation of innovative preventive approaches. It highlights the linear dose-response relationship between pack-years and the prevalence of subclinical multi-territorial atherosclerosis and demonstrates that the classic SCORE-2 scale systematically underestimates cardiovascular risk in heavy smokers, particularly women. Assessments of vascular aging using artificial intelligence identified tobacco smoking as the most potent factor accelerating biological vascular age; it exerts a mutually aggravating synergistic effect when combined with elevated non-HDL cholesterol levels and arterial hypertension. Regarding secondary prevention following acute coronary syndrome and in cases of vasospastic angina, the article substantiates the critical importance of complete nicotine cessation within the first few days after hospital discharge. The comparative efficacy of traditional pharmacotherapy for tobacco dependence (highlighting the superiority of varenicline and cytisinicline) has been evaluated, breakthrough results from the use of glucagon-like peptide-1 (GLP-1) receptor agonists have been demonstrated, and the evidence-based concept of cardiovascular harm reduction through a complete switch to smokeless alternatives for smokers with severe nicotine dependence has been examined.

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