The German CPU registry: Comparison of smokers and nonsmokers
The German CPU registry: Comparison of smokers and nonsmokers
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DOI：
10.1007/s00059-018-4733-z
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发表时间：
2020-05-01
期刊：
影响因子：
1.7
通讯作者：
Hink, U.
中科院分区：
文献类型：
--
作者：
Bock, D.;Senges, J.;Hink, U.
背景 胸痛是进入内科急诊的主要原因，而吸烟是众所周知的冠状动脉疾病 (CAD) 和急性冠状动脉综合征 (ACS) 的危险因素。本分析的目的是说明在德国胸痛科 (CPU) 就诊的吸烟者和非吸烟者在患者特征、CAD 表现、治疗策略和预后方面的差异。 方法 从 2008 年 12 月到 2014 年 3 月，德国 CPU 登记处登记了 13,902 名进行了完整 3 个月随访的患者。该分析包括 5796 名 ACS 患者并记录了吸烟状况。结果 在 CPU 登记的所有患者中，35.2% 是吸烟者。与不吸烟者相比，他们年轻 13.5 岁（58.2 岁 vs. 71.7 岁，p < 0.001），主要为男性（77.1% vs. 65.2%，p < 0.001），并且更常被诊断为单支血管疾病（32.1% vs. 25.2%）以及 ST 段抬高型心肌梗死（STEMI；23.8%）对比 15.5%，p < 0.001）。尽管全球急性冠脉事件登记处 (GRACE) 的医院死亡率风险评分在吸烟者组中较低（106.1 比 123.3，p < 0.001），但我们没有观察到吸烟者组之间 CPU 死亡（0.4% 比 0.4%，p = 0.69）和 CPU 主要不良心脏事件（MACE）率（3.8% 比 2.9%，p = 0.073）有任何差异。团体。在 3 个月的随访中，我们记录了非吸烟者组的较高死亡率（1.9% vs. 2.9%，p = 0.035），与 GRACE 风险评分（80.3 vs. 105.2，p < 0.001）相关。随访期间 MACE 发生率相似（3.1% 与 4.1%，p = 0.065）。 结论 德国 CPU 登记处的观察结果表明，吸烟是生命早期急性 CAD 表现（尤其是 STEMI）的有力预测因素。尽管 GRACE 风险评分较低且合并症较少，但吸烟者的医院死亡率与老年非吸烟者相似。
Background Chest pain is a major reason for admission to an internal emergency department, and smoking is well-known risk factor for coronary artery disease (CAD) and acute coronary syndrome (ACS). The aim of this analysis is to illustrate the differences between smokers and nonsmokers presenting to German chest pain units (CPU) in regard to patient characteristics, CAD manifestation, treatment strategy, and prognosis.Methods From December 2008 to March 2014, 13,902 patients who had a complete 3-month follow-up were enrolled in the German CPU registry. The analysis comprised 5796 patients with ACS and documented smoking status.Results Of all the patients in the CPU registry, 35.2% were smokers. Compared with nonsmokers, they were 13.5 years younger (58.2 vs. 71.7 years, p < 0.001), predominantly men (77.1% vs. 65.2%, p < 0.001), and were more frequently diagnosed with single-vessel disease (32.1% vs. 25.2%) as well as ST-elevation myocardial infarction (STEMI; 23.8% vs. 15.5%, p < 0.001). Although the Global Registry of Acute Coronary Events (GRACE) Risk Score for hospital mortality was lower in the group of smokers (106.1 vs. 123.3, p < 0.001), we did not observe any differences in CPU death (0.4% vs. 0.4%, p = 0.69) and CPU major adverse cardiac event (MACE) rates (3.8% vs 2.9%, p = 0.073) between the groups. In the 3-month follow-up, we documented higher mortality rates in the nonsmoker group (1.9% vs. 2.9%, p = 0.035) in correlation with the GRACE Risk Score (80.3 vs. 105.2, p < 0.001). MACE rates were similar during the follow-up (3.1% vs. 4.1%, p = 0.065).Conclusion Observations from the German CPU registry demonstrate that smoking is a strong predictor of acute CAD manifestation early in life, especially STEMI. In spite of a lower GRACE Risk Score and fewer comorbidities, smokers had a rate of hospital mortality similar to the older group of nonsmokers.