吸烟对于急性冠脉综合症行冠状动脉介入治疗患者短期及长期预后的影响  

Impact of Smoking status on In-hospital and long-term Complications in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention.

作　　者：王欢欢[1] 宋莹[1] 许晶晶[1] 马元良[1] 刘如[1] 姜琳[1] 蒋萍[1] 高立建[1] 宋雷[1] 张茵[1] 赵雪燕[1] 高展[1] 陈珏[1] 乔树宾[1] 杨跃进[1] 高润霖[1] 徐波[1] 袁晋青[1] 

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院心血管病国家实验室,北京市100037

出　　处：《中国分子心脏病学杂志》2017年第5期2221-2224,共4页Molecular Cardiology of China

基　　金：国家重点研发计划项目(2016YFC1301301);国家自然科学基金面上项目(81470486)

摘　　要：目的探讨吸烟对于行冠状动脉介入的患者住院期间及长期预后的影响。方法连续纳入了自2013年1月份至12月份于中国医学科学院阜外医院行介入治疗的急性冠脉综合症患者6431例,根据吸烟状态分为非吸烟组和吸烟组,观察吸烟对行冠状动脉介入治疗患者短期及长期预后的影响。结果吸烟组患者年龄更小、男性为主且平均住院时间更短,住院期间全因死亡及心源性死亡吸烟组明显低于非吸烟组(0.1%vs 0.4%,P=0.015;0.1%vs 0.4%,P=0.048);而在出血、脑卒中、支架内血栓以及新发心肌梗死事件发生率方面两组无显著差异。2年随访结果显示:吸烟组的脑卒中和心源性死亡发生率明显低于非吸烟组(1.2%vs 1.8%,P=0.036;0.6%vs 1.1%,P=0.026),而全因死亡两组间无显著差异。多因素分析显示吸烟并非院内死亡率以及2年随访时脑卒中、心源性死亡的独立预测因子。结论对于行冠状动脉介入治疗的患者,吸烟患者的短期及长期预后好于非吸烟者,但吸烟并非独立预测因子。Objective To investigate the impact of smoking status on in-hospital and long-term complications in acute coronary syndrome（ACS） patients undergoing percutaneous coronary intervention.Methods A data from Fuwai Hospital including a total of 6431 consecutive patients admitted and underwent percutaneous coronary interventional therapy were analyzed.Results The all cause death and cardia death for smoking patients were significantly lower than non-smokers（0.1% vs 0.4%,P=0.015,0.1% vs 0.4%,P=0.048,respectly）; there was no significant difference in bleeding,stroke,stent thrombosis,reinfarction and revascularization.2 years of follow-up results showed that in smoking patients the stroke rate and cardia death were significantly lower than that in non-smokers（1.2% vs 1.8%,P=0.036,0.6% vs 1.1%,P=0.026,respectly）,the two groups had no significant difference in all cause death.Multivariable Cox regression analysis indicated that smoking status was not an independent predictor of in-hospital mortality,stroke and cardia death in 2 years follow-up.Conclusion For ACS patients with coronary intervention,the early and long-tem outcomes of smoking patients were better than non smokers,but smoking status is not an independent predictor of mortality.

关 键 词：吸烟 冠状动脉粥样硬化性心脏病 经皮冠状动脉介入治疗 

分 类 号：R541.4[医药卫生—心血管疾病]