术前吸烟状况和冠状动脉旁路移植后的长期存活率:竞争性风险分析
Armando Abreu1,2, José Máximo1,2, Adelino Leite-Moreira1,2
1Cardiovascular R&D Center-UnIC@RISE, Department of Surgery and Physiology, Faculty of Medicine of the University of Porto, Porto, Portugal.
概括
在冠状动脉旁路移植术后继续吸烟显著增加晚期死亡风险,主要是由于非心脏原因. 戒烟与心脏病死亡率降低有关,改善了严重冠状动脉疾病患者的长期存活率.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 胸部外科手术 胸部外科手术
背景情况:
- 冠状动脉旁路移植 (CABG) 后继续吸烟与晚期死亡率的增加有关.
- 具体的机制,特别是心脏病死亡率的作用,仍然不清楚.
研究的目的:
- 在单独的CABG后,研究吸烟状态对长期全因和因特定死亡率的影响.
- 为了区分与当前吸烟和前吸烟相关的死亡风险.
主要方法:
- 对5242名接受初级隔离CABG的患者进行了回顾性分析.
- 患者被分为非吸烟者,前吸烟者 (>1年) 和目前吸烟者.
- 长期所有原因和特定原因 (心血管,非心血管) 死亡率使用Fine和Gray分发危险模型进行评估.
主要成果:
- 与非吸烟者相比,目前吸烟者面临24%的晚期全因死亡风险增加.
- 当前吸烟显著增加非心脏病死亡 (61%的相对发病率),但心脏病死亡减少 (25%的相对发病率).
- 前吸烟者 (>1年) 的生存率与非吸烟者相同.
结论:
- 目前的吸烟增加了CABG后晚期死亡风险,主要是由于非心脏原因.
- 戒烟似乎可以减轻心脏病死亡风险.
- 前吸烟者与非吸烟者之间的长期存活率相似.
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