中国全科医学2012，Vol.15Issue(26)：2996-2999,3002,5.DOI:10.3969/j.issn.1007-9572.2012.09.043
吸烟对急性ST段抬高型心肌梗死接受紧急冠状动脉介入治疗患者预后影响的前瞻性多中心队列研究
Impact of Smoking Status on Prognosis in Patients with Acute ST-segment Elevation Myocardial Infarction after Emergency Percutaneous Coronary Intervention,A Prospective,Multi-center Cohort Study
摘要
Abstract
Objective To evaluate the impact of smoking status on the prognosis of patients with acute ST - segment elevation myocardial infarction ( ASTEMI ) after percutaneous coronary intervention ( PCI ). Methods In this prospective, multi - center cohort study, the consecutive ASTEMI patients who were admitted to 20 hospitals between May 2009 and May 2010 in Liaoning Province were enrolled. Patients were divided into smoker group and non - smoker group on admission. The baseline demographic data, treatment and clinical outcomes were compared between these two groups. The survival curves, log - rank test, and Cox proportional hazard analysis were applied. Results Totally 402 patients were enrolled, among whom 228 patients were in the smoker group and 174 patients in non - smoker group, yielding a smoking rate of 56. 7% ( n = 228 ). The smoker group was significantly younger than the non - smoker group [ ( 56. 47 ± 10. 90 ) y vs. ( 64. 86 ± 11. 97 ) y, P < 0. 001 ]. There was significantly more men in the smoker group than in non - smoker group ( 94. 7% vs 61. 5% , P <0. 001 ). The non -smoker group had significantly higher incidences of myocardial infarction, hypertension and diabetes than the smoker group ( P < 0. 05 ). The non - smoker group had significantly higher rate of multi - vessels disease than smoker group but lower rate of single vessel disease ( P <0. 05 ). The mortality ( both in - hospital and follow - up: P =0. 19 ) and the cumulative survival rate ( in -hospital: P =0. 53 ; follow - up: P = 0. 08 ) showed no significant difference between these two groups. The mortality was sig- nificantly correlated with age [ HR = 1. 118, 95% CI (1.069, 1.168), P<0. 001], body mass index [ HR = 1. 113, 95% CI ( 1.107, 1.219), P=0. 02), and smoking status [ HR =3. 549, 95% CI ( 1.305, 9.650), P = 0. 01]. Conclusion Among patients with ASTEMI after PCI, smokers are younger, with lower comorbiditiess and simpler lesions. Although the short - and long - term prognosis of the smokers seem to be better than non - smokers, no significant difference exists. Age, body mass index, and smoking status are the independence risk factors of mortality.关键词
吸烟/急性ST段抬高心肌梗死/血管成形术,经腔,经皮冠状动脉Key words
Smoking/ Acute ST - segment elevation myocardial infarction/ Angioplasty, transluminal, percutaneous coronary分类
医药卫生引用本文复制引用
孙宇姣,姜大明,张波,孙洋,高远,李玉泽,于海杰,齐国先..吸烟对急性ST段抬高型心肌梗死接受紧急冠状动脉介入治疗患者预后影响的前瞻性多中心队列研究[J].中国全科医学,2012,15(26):2996-2999,3002,5.基金项目
辽宁省科学技术计划项目(200822500) （200822500）
