Impact of Cigarette Smoking in High-Risk Patients Participating in a Clinical Trial. A Substudy from the Heart Outcomes Prevention Evaluation (HOPE) Trial
Impact of Cigarette Smoking in High-Risk Patients Participating in a Clinical Trial. A Substudy from the Heart Outcomes Prevention Evaluation (HOPE) Trial
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吸烟对参加临床试验的高危患者的影响。
DOI：
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发表时间：
2005
影响因子：
--
通讯作者：
S. Yusuf
中科院分区：
文献类型：
--
作者：
G. Dagenais;Q. Yi;E. Lonn;P. Sleight;J. Ostergren;S. Yusuf
在最近的大型心血管试验中，14-31%的参与者是吸烟者;在这些试验中使用已知可减少心血管事件的药物，吸烟的后果尚未评估。设计：我们根据参与心脏预后预防评价试验的男性和女性的吸烟状况评估心血管预后。方法记录试验期间未改变吸烟状态的受试者的心血管事件发生情况。有2728名“从不吸烟者”，5241名“以前吸烟者”和936名“现在吸烟者”，所有人都有稳定的心血管疾病或糖尿病，至少有一个其他风险因素。无既往充血性心力衰竭或已知左心室射血分数< 0.40。结果随访4.5年，心血管死亡641例，心肌梗死978例，脑卒中358例，死亡1021例。与“从不吸烟者”相比，吸烟者的相对危险度经混杂变量校正后，包括已知可降低心血管死亡率和发病率的药物，心血管死亡为1.65 [95%置信区间（CI），1.28-2.14]，心肌梗死为1.26（95% CI，1.01-1.58），卒中为1.42（95% CI，1.00-2.04），总死亡率为1.99（95% CI，1.63-2.44）。这些事件在“前吸烟者”中的发生率与“从不吸烟者”没有差异。结论：尽管使用已知可减少心血管事件的药物，吸烟仍增加了高危患者的死亡率和发病率。戒烟计划应加强，即使是参与临床试验的患者。
Background In recent large cardiovascular trials done in stable patients, 14-31% of the participants were smokers; the consequences of smoking in these trials using medications known to reduce cardiovascular events, have not been assessed. Design We evaluated the cardiovascular outcomes according to smoking status of men and women participating in the Heart Outcomes Prevention Evaluation trial. Methods The occurrence of cardiovascular events was documented among participants who did not change their smoking status during the trial. There were 2728 ‘never smokers’, 5241 ‘former smokers’ and 936 ‘current smokers’, and all had stable cardiovascular disease or diabetes with at least one other risk factor. None had previous congestive heart failure or known left ventricular ejection fraction < 0.40. Results During the 4.5-year follow-up, there were 641 cardiovascular deaths, 978 myocardial infarctions, 358 strokes and 1021 deaths. In comparison to ‘never smokers’, smokers had relative risks adjusted for confounding variables including medications known to reduce cardiovascular mortality and morbidity, for cardiovascular death of 1.65 [95% confidence interval (CI), 1.28-2.14], for myocardial infarction of 1.26 (95% CI, 1.01-1.58), for stroke of 1.42 (95% CI, 1.00-2.04), and for total mortality of 1.99 (95% CI, 1.63-2.44). The rates of these events among ‘former smokers’ were not different from those of ‘never smokers’. Conclusions Smoking increased the risk of mortality and morbidity among high-risk patients despite the use of medications known to reduce cardiovascular events. Smoking cessation programs should be reinforced even for patients participating in clinical trials.
影响因子：
12.7
作者：
PATRICK, DL;CHEADLE, A;KINNE, S
通讯作者：
KINNE, S