吸烟和冠状动脉旁路移植后的患病和死亡的长期风险
Emelie Johansson1,2, Malin Stenman3,4, Emma C Hansson1,2
1Department of Molecular and Clinical Medicine, Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden.
International journal of cardiology. Cardiovascular risk and prevention
|December 30, 2025
概括
在冠状动脉旁路移植 (CABG) 后,吸烟显著增加了死亡率和主要不良心血管事件 (MACE) 的长期风险. 当前吸烟者面临的风险最高,这强调了在CABG后需要戒烟支持的必要性.
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:
- 冠状动脉旁路移植 (CABG) 是心血管疾病的关键干预措施.
- 吸烟对CABG后结果的长期影响需要进一步调查.
- 了解吸烟相关风险对于患者管理和公共卫生战略至关重要.
研究的目的:
- 调查接受CABG的患者吸烟状态与长期发病率和死亡率之间的关联.
- 量化目前和前吸烟者的重大心血管不良事件 (MACE),全因死亡率和中风风险,与CABG后从未吸烟者的风险相比.
- 突出戒烟在改善CABG后患者治疗结果方面的重要性.
主要方法:
- 一个基于人口的注册表研究,利用来自SWEDEHEART注册表的数据.
- 包括27,434名在2010年至2020年期间接受CABG的患者,分为从未吸烟者,前吸烟者和目前吸烟者.
- 使用调整的考克斯回归模型进行分析,以估计死亡率和发病率的危险比率,随访时间中位数为5年.
主要成果:
- 与从未吸烟者相比,目前吸烟者对MACE (aHR 1.52),全因死亡率 (aHR 1.91) 和中风 (aHR 1.49) 的风险更高.
- 与前吸烟者相比,目前吸烟者患MACE (aHR 1.38),全因死亡率 (aHR 1.53) 和中风 (aHR 1.36) 的风险增加.
- 与从未吸烟者 (aHR 1.07) 或前吸烟者 (aHR 1.15) 相比,目前吸烟者没有发现心肌梗塞的显著增加风险.
结论:
- 吸烟与CABG后死亡率和发病率的长期风险增加之间存在着强烈的联系.
- 目前的吸烟者面临的风险最为严重,强调戒烟干预措施的急需性.
- 在CABG之前激励患者戒烟对于优化长期健康结果至关重要.
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