Serum Cotinine and Silent Myocardial Infarction in Individuals Free from Cardiovascular Disease
Serum Cotinine and Silent Myocardial Infarction in Individuals Free from Cardiovascular Disease
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DOI：
10.1016/j.amjcard.2019.05.064
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发表时间：
2019-09-01
影响因子：
2.8
通讯作者：
Soliman, Elsayed Z.
中科院分区：
文献类型：
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作者：
Brunetti, Ryan;Hicklin, Harry;Soliman, Elsayed Z.
血清可替宁是烟草暴露的一个敏感和特异的标志，包括二手烟暴露。我们试图探索血清可替宁确定的烟草暴露与心电图无症状性心肌梗死(SMI)的相关性。第三次全国健康和营养检查调查(NHANES III)共有7,006名无心血管疾病的参与者(59.0+/-13.3岁；52.6%的女性，49.7%的非西班牙裔白人)被纳入这项分析。SMI被定义为无心肌梗塞病史的心肌梗塞的心电图证据。采用多变量Logistic回归分析检测SMI与血清可替宁水平之间的关系。114名受试者(1.63%)检出SMI。血清Cotinine水平较高者SMI患病率较高(分别为1.25%、1.49%和2.14%，分别为0.03~0.12 ng/m1、0.12~1.39 ng/ml和1.40~1890 ng/ml)。在调整了潜在混杂因素的模型中，与血清可替宁水平最高的三分体的参与者相比，血清可替宁水平最高的三分体的参与者发生SMI的几率显著更高(优势比[95%可信区间]：2.51[1.55至4.08])。血清可替宁水平每升高10 ng/ml，重度心肌梗死的患病率增加2%(p<；0.0001)。这种关联在白人参与者中比非白人参与者更强(交互作用p值=0.05)。总而言之，血清可替宁水平升高与SMI有关。这些发现进一步强调了被动和主动吸烟对心血管健康的相关风险，并强调了血清可替宁在识别高危人群方面的潜在效用。(C)2019 Elsevier Inc.保留所有权利。
Serum cotinine is a sensitive and specific marker of tobacco exposure, including second-hand smoke exposure. We sought to explore the association of tobacco exposure determined by serum cotinine with electrocardiographic silent myocardial infarction (SMI). A total of 7,006 participants (59.0 +/- 13.3 years; 52.6% women, 49.7% non-Hispanic whites) without cardiovascular disease from the Third National Health and Nutrition Examination Survey (NHANES III) were included in this analysis. SMI was defined as electrocardiographic evidence of MI in the absence of a history of MI. Multivariable logistic regression analysis was used to examine the association between SMI and serum cotinine tertiles. SMI was detected in 114 (1.63 %) of the participants. The prevalence of SMI was higher among those with higher levels of serum cotinine (SMI prevalence was 1.25%, 1.49%, and 2.14% across serum cotinine lower [0.03 to 0.12 ng/m1], middle [0.12 to 1.39 ng/ml], and higher [1.40 to 1890 ng/ml] tertiles, respectively). In a model adjusted for potential confounders, participants within the highest serum cotinine tertile had significantly greater odds of SMI (odds ratio [95% confidence interval]: 2.51 [1.55 to 4.08]) compared with those with serum cotinine levels in the first tertile. Each 10 ng/ml increase in serum cotinine levels was associated with a 2% (p < 0.0001) increase in the prevalence of SMI. This association was stronger in white than nonwhite participants (interaction p value = 0.05). In conclusion, elevated serum cotinine levels are associated with SMI. These findings further highlight the risk associated with passive and active smoking on cardiovascular health and underscore the potential utility of serum cotinine in identifying those at risk. (C) 2019 Elsevier Inc. All rights reserved.