吸烟对冠状动脉介入治疗患者预后影响的性别差异分析  

Differential impact of cigarette smoking on prognosis in women and men undergoing percutaneous coronary intervention

作　　者：杨丽霞[1] 周玉杰[1] 王志坚[1] 柴萌[1] 梁静[1] 张琳琳[1] YANG Lixia;ZHOU Yujie;WANG Zhijian;CHAI Meng;LIANG Jing;ZHANG Linlin(Department of Cardiology,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases,Beijing 100029,China)

机构地区：[1]首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所干部保健科

出　　处：《心肺血管病杂志》2019年第11期1097-1101,共5页Journal of Cardiovascular and Pulmonary Diseases

基　　金：北京市保健局课题:吸烟对冠状动脉介入治疗患者预后影响的性别差异(京17-10)

摘　　要：目的:探讨吸烟对经皮冠状动脉介入(PCI)治疗后男女性患者长期预后的影响及交互作用。方法:调查2013年1月1日至2014年12月31日,于安贞医院行择期PCI的患者约10369例,所有患者根据性别和吸烟状态分为男性吸烟组,男性不吸烟组,女性吸烟组,女性不吸烟组。结果:择期PCI患者男性7773例和女性2596例,男性吸烟比率66.7%(n=5185),女性11.0%(n=286,P<0.001)。中位随访时间20.6个月,2489例(48%)男性戒烟,88例女性戒烟(30.7%,P<0.001)。吸烟增加女性主要不良心血管(MACE)事件较男性更显著(女性:HR:3.68,95%CI:1.8~7.28,P<0.001;男性:HR:1.35,95%CI:1.03~1.77,P=0.005,交互作用P=0.026)。结论:在行PCI治疗的患者中男性吸烟比率较女性更高,但吸烟对女性MACE事件的影响较男性更显著。Abjective:To compare the effects of smoking on the clinical outcomes in women and men undergoing percutaneous coronary intervention(PCI).Cigarette smoking is an important risk factor for worse outcomes in patients with coronary artery disease(CAD).Whether smoking confers the same excess risk for women as that for men is not known.Methods:We prospectively followed up 10,369 patients undergoing elective PCI between January 2013 and December 2014.All patients were stratified according to smoking status and sex.The impacts of smoking on long-term major adverse cardiovascular events(MACE,the composite of allcause death,myocardial infarction,or target vessel revascularization)among men and women were assessed.Results:Among 7773 men and 2596 women undergoing PCI,the prevalence of cigarette smoking was 66.7%(n=5185)and 11.0%(n=286),P<0.001.During the 3 years of follow-up(median:20.6 months),2489 men(48.0%)and 88 women(30.7%)quit smoking(P<0.001).Smoking increased MACE in both men and women(Men,10.8%vs.8.1%,P<0.001;women 23.2%vs.6.4%,P<0.001).After adjusting for baseline characteristics,smoking had a greater effect on MACE in women(HR:3.68,95%CI:1.86-7.28,P<0.001)compared with men(HR:1.35,95%CI:1.03-1.77,P=0.005,interaction P=0.026).Conclusions:Despite a low prevalence of smoking in women compared to men among patients undergoing PCI,smoking confers a higher excess risk for MACE among women compared with men.

关 键 词：冠状动脉介入治疗 吸烟 女性 

分 类 号：R54[医药卫生—心血管疾病]