Association of household secondhand smoke exposure and mortality risk in patients with heart failure
Association of household secondhand smoke exposure and mortality risk in patients with heart failure
复制标题
家庭二手烟暴露与心力衰竭患者死亡风险的关系
DOI：
10.1186/s12872-019-1269-y
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发表时间：
2019-12-02
影响因子：
2.1
通讯作者：
Liu, Chen
中科院分区：
文献类型：
--
作者：
He, Xin;Zhao, Jingjing;Liu, Chen
背景：二手烟暴露是一个公认的心血管危险因素，但二手烟暴露与心力衰竭预后之间的关系仍不确定。方法资料来源于1988 ~ 1994年美国国家健康与营养调查III。目前不吸烟且自我报告有心力衰竭史的成年人也包括在内。采用问卷调查的方式评估家庭SHS暴露情况。参与者的随访一直持续到2011年12月31日。Cox比例风险模型用于评估家庭SHS暴露与死亡风险之间的关系。对潜在的混杂因素进行调整。结果572例不吸烟的心力衰竭患者中，88例暴露于家庭SHS， 484例未暴露于家庭SHS。随访期间共有475人死亡。在单因素分析中，家庭SHS与死亡风险无关（风险比[HR]: 0.98, 95%可信区间[CI]: 0.76-1.26, p = 0.864）。然而，在调整人口统计学变量、社会经济变量和药物后，暴露组心力衰竭患者的死亡风险比未暴露组增加43% （HR: 1.43, 95% CI: 1.10-1.86, p = 0.007）。进一步调整一般健康状况和合并症的分析结果相似（HR: 1.47, 95% CI: 1.13-1.92, p = 0.005）。结论家庭SHS暴露与心力衰竭患者死亡风险增加有关。
Background Secondhand smoke (SHS) exposure is a well-established cardiovascular risk factor, yet association between SHS and prognosis of heart failure remains uncertain. Method Data were obtained from the US National Health and Nutrition Examination Surveys III from 1988 to 1994. Currently nonsmoking adults with a self-reported history of heart failure were included. Household SHS exposure was assessed by questionnaire. Participants were followed up through December 31, 2011. Cox proportional-hazards models were used to assess the association of household SHS exposure and mortality risk. Potential confounding factors were adjusted. Results Of 572 currently nonsmoking patients with heart failure, 88 were exposed to household SHS while 484 were not. There were totally 475 deaths during follow-up. In univariate analysis, household SHS was not associated with mortality risk (hazard ratio [HR]: 0.98, 95% confidence interval [CI]: 0.76-1.26, p = 0.864). However, after adjustment for demographic variables, socioeconomic variables and medication, heart failure patients in exposed group had a 43% increase of mortality risk compared with those in unexposed group (HR: 1.43, 95% CI: 1.10-1.86, p = 0.007). Analysis with further adjustment for general health status and comorbidities yielded similar result (HR: 1.47, 95% CI: 1.13-1.92, p = 0.005). Conclusion Household SHS exposure was associated with increased mortality risk in heart failure patients.