Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial.
Effects of smoking and smoking cessation on endothelial function: 1-year outcomes from a randomized clinical trial.
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DOI：
10.1016/j.jacc.2010.03.002
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发表时间：
2010-05-04
影响因子：
24
通讯作者：
Stein, James H.
中科院分区：
文献类型：
--
作者：
Johnson, Heather M.;Gossett, Linda K.;Piper, Megan E.;Aeschlimann, Susan E.;Korcarz, Claudia E.;Baker, Timothy B.;Fiore, Michael C.;Stein, James H.
确定戒烟是否改善肱动脉（BA）的血流介导性扩张（FMD）。持续吸烟和戒烟对内皮功能的长期影响以前没有描述过。这是一项为期一年的前瞻性、双盲、随机、安慰剂对照临床试验，研究5种戒烟药物治疗的效果。在目标戒烟日期之前和之后1年通过B型超声测量FMD。通过呼出的一氧化碳水平来验证停止。在研究组之间以及成功戒烟和继续吸烟的受试者之间比较ΔFMD。通过多变量回归确定基线FMD和ΔFMD的预测因子。1，504名当前吸烟者（58%为女性，84%为白色）的平均年龄（标准差）为44.7（11.1）岁，每天吸烟21.4（8.9）支。基线FMD在每个治疗组中相似（p=0.499），并且通过BA直径（p<0.001）、反应性充血血流量（p<0.001）、高密度脂蛋白胆固醇（p=0.001）和一氧化碳（p=0.012）水平进行预测。一年后，36.2%的人戒烟。戒烟者1年后FMD增加了1% [6.2%（4.4%）至7.2%（4.2%）]（p=0.005），但继续吸烟者没有变化（p=0.643）。在控制了BA直径、反应性充血、低密度脂蛋白胆固醇和家庭禁烟的变化后，戒烟者的FMD改善仍然显著（p=0.010）。尽管体重增加，戒烟导致内皮功能的长期改善，这可能介导戒烟后观察到的心血管疾病风险降低的一部分。
To determine if smoking cessation improves flow-mediated dilation (FMD) of the brachial artery (BA). The long-term effects of continued smoking and smoking cessation on endothelial function have not been described previously. This was a one-year, prospective, double-blind, randomized, placebo-controlled clinical trial of the effects of 5 smoking cessation pharmacotherapies. FMD was measured by B-mode ultrasound before and 1-year after the target smoking cessation date. Cessation was verified by exhaled carbon monoxide levels. ΔFMD was compared among study arms and between subjects that successfully quit and those who continued to smoke. Predictors of baseline FMD and ΔFMD were identified by multivariable regression. The 1,504 current smokers (58% female, 84% white) were mean (standard deviation): 44.7 (11.1) years old and smoked 21.4 (8.9) cigarettes/day. Baseline FMD was similar in each treatment arm (p=0.499) and was predicted by BA diameter (p<0.001), reactive hyperemia blood flow (p<0.001), high-density lipoprotein cholesterol (p=0.001), and carbon monoxide (p=0.012) levels. After one year, 36.2% quit smoking. FMD increased by 1% [6.2% (4.4%) to 7.2% (4.2%)] after 1 year (p=0.005) in those who quit, but did not change (p=0.643) in those who continued to smoke. Improved FMD among quitters remained significant (p=0.010) after controlling for changes in BA diameter, reactive hyperemia, low-density lipoprotein cholesterol, and presence of a home smoking ban. Despite weight gain, smoking cessation leads to prolonged improvements in endothelial function, which may mediate part of the reduced cardiovascular disease risk observed after smoking cessation.
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影响因子：
--
作者：
Piper, Megan E.;Smith, Stevens S.;Baker, Timothy B.
通讯作者：
Baker, Timothy B.
影响因子：
37.8
作者：
Yeboah, Joseph;Crouse, John R.;Herrington, David M.
通讯作者：
Herrington, David M.
影响因子：
5.6
作者：
Freund, K M;Belanger, A J;Kannel, W B
通讯作者：
Kannel, W B
影响因子：
4.4
作者：
FAGERSTROM, KO;BATES, S
通讯作者：
BATES, S
影响因子：
158.5
作者：
ROSENBERG, L;PALMER, JR;SHAPIRO, S
通讯作者：
SHAPIRO, S