Secondhand smoke and atrial fibrillation: Data from the Health eHeart Study.
Secondhand smoke and atrial fibrillation: Data from the Health eHeart Study.
复制标题
二手烟和心房颤动：健康EHEART研究的数据。
DOI：
10.1016/j.hrthm.2015.08.004
复制
发表时间：
2016-01
期刊：
影响因子：
5.5
通讯作者：
Marcus GM
中科院分区：
文献类型：
--
作者：
Dixit S;Pletcher MJ;Vittinghoff E;Imburgia K;Maguire C;Whitman IR;Glantz SA;Olgin JE;Marcus GM
吸烟是房颤(AF)的危险因素，但二手烟(SHS)是否会影响房颤的风险仍不清楚。以确定SHS暴露是否与房颤风险增加相关。我们对参加健康心脏研究的参与者的数据进行了横断面分析，这是一项基于互联网的纵向心血管队列研究，他们完成了基线SHS暴露和医疗状况问卷。SHS通过验证的22个问题的调查进行评估，流行的房颤通过自我报告进行评估，并通过回顾电子医疗记录来验证子集(n=42)。在4976名参与者中，593名(11.9%)报告有房颤。在未经调整的分析中，房颤患者更有可能在子宫内、儿童时期、成年后、家庭和工作中接触过SHS。对可能的混杂因素进行多因素调整后，孕期父母吸烟(OR1.37，95%CI1.08~1.73，p=0.009)和儿童期与吸烟者同住(OR1.40，95%CI1.10~1.79，p=0.007)均与房颤发生显著相关。这两种正相关关系在没有房颤危险因素的患者中更为明显(交互作用的p值为0.05)。妊娠期和儿童期的SHS暴露与晚年的房颤有关。在没有确定的房颤危险因素的情况下，这种关联性更强。我们的发现表明，早期生活中的SHS可能是房颤发生的一个重要的、潜在的可改变的危险因素。
Cigarette smoking is a risk factor for atrial fibrillation (AF), but whether secondhand smoke (SHS) impacts the risk of AF remains unknown. To determine if SHS exposure is associated with an increased risk of AF. We performed a cross-sectional analysis of data from participants enrolled in the Health eHeart Study, an internet-based, longitudinal cardiovascular cohort study, who completed baseline SHS exposure and medical conditions questionnaires. SHS was assessed through a validated 22-question survey, and prevalent AF was assessed by self-report, with validation of a subset (n=42) by review of electronic medical records. Of 4,976 participants, 593 (11.9%) reported having AF. In unadjusted analyses, patients with AF were more likely to have been exposed to SHS in utero, as a child, as an adult, at home, and at work. After multivariable adjustment for potential confounders, having had a smoking parent during gestational development (OR 1.37, 95% CI 1.08–1.73, p=0.009) and residing with a smoker during childhood (OR 1.40, 95% CI 1.10–1.79, p=0.007) were each significantly associated with AF. Both positive associations were more pronounced among patients without risk factors for AF (p values for interaction <0.05). SHS exposure during gestational development and during childhood was associated with having AF later in life. This association was even stronger in the absence of established risk factors for AF. Our findings indicate that SHS in early life may be an important, potentially modifiable risk factor for the development of AF.