在以前患有冠状动脉疾病的患者中吸烟和心脏突然死亡
Minna Järvensivu-Koivunen1, Jussi Hernesniemi1,2, Juho Tynkkynen3
1Faculty of Medicine and Health Technology, Tampere University.
在急性冠状动脉综合征 (ACS) 之后,活跃吸烟者面临心脏突然死亡 (SCD) 的风险明显更高. 戒烟对于降低这些患者的SCD风险至关重要.
科学领域:
- 心脏病学 心脏病学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 在一般人群中,吸烟是心脏突然死亡 (SCD) 的已知危险因素.
- 吸烟对急性冠状动脉综合征 (ACS) 患者的SCD风险的影响尚未得到充分证实.
研究的目的:
- 为了研究吸烟状态和ACS患者中SCD风险之间的关联.
- 为了确定活跃吸烟或前吸烟是否影响ACS幸存者的未来SCD风险.
主要方法:
- 从心血管研究数据库中分析了9704名ACS患者的吸烟数据.
- 利用SCD的复合终点,包括堕胎的SCD和心室心律不整的除器治疗.
- 采用多变量细灰色竞争风险回归,调整传统心血管风险因素.
主要成果:
- 与非吸烟者相比,活跃吸烟者的SCD风险增加了79% (多变量危险比1.79).
- 在前吸烟者中没有观察到增加SCD风险.
- 活跃吸烟者在基线时明显年轻于非吸烟者和前吸烟者.
结论:
- 活跃吸烟是ACS患者中SCD的重要独立风险因素.
- 应强烈建议在ACS后戒烟,以减轻SCD风险.
- 吸烟状态应纳入SCD和植入式心脏转换器-除器治疗的风险分层模型.
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