Smoking status at the time of acute myocardial infarction and subsequent prognosis.

Smoking status at the time of acute myocardial infarction and subsequent prognosis.
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急性心肌梗死时的吸烟状况及其预后。

DOI:
10.1016/0002-8703(85)90071-7
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发表时间:
1985
影响因子:
4.8
通讯作者:
RossJr,J
RossJr,J
中科院分区:
医学2区
文献类型:
--
作者:
Kelly,TL;Gilpin,E;Ahnve,S;Henning,H;RossJr,J

文献摘要

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对 2955 名因急性心肌梗死 (AMI) 入院的患者进行了为期 1 年的随访或直至死亡。与不吸烟者相比,吸烟者年轻10岁以上(p<0.001),高血压(p<0.01)、充血性心力衰竭(p<0.0001)、心绞痛(p<0.01)和糖尿病(p<0.0001)患病率较低。他们的心肌梗塞不太严重,例如胸部 X 光检查显示的肺充血患病率较低(p < 0.01)。吸烟人群的早期(1个月)和晚期(6个月和12个月)死亡率均较低(1个月时p<0.0001,6个月时p<0.05,1年时p<0.01)。对年龄和其他变量进行调整后,吸烟者在 1 个月时的生存差异有所减少,但并未逆转,但仅对年龄进行调整就消除了 6 个月和 12 个月时死亡率的差异。我们的结论是,虽然吸烟是心血管疾病的危险因素,并且可能导致年轻时发生 AMI,但 AMI 时吸烟似乎并不是 AMI 后第一年死亡的独立预测因素。
A population of 2955 patlents admitted to the hospital with acute myocardial infarction (AMI) was followed for 1 year after AMI or until death. Smokers as compared to nonsmokers were over 10 years younger (p< 0.001) and had a lower prevalence of hypertension (p< 0.01), congestive heart failure (p< 0.0001), angina pectoris (p< 0.01), and diabetes (p< 0.0001). They had less severe myocardial infarction evidenced, for example, by lower prevalence of pulmonary congestion on chest x-ray (p< 0.01). Both early (1 month) and late (6 and 12 months) mortality rates were lower in the smoking population (p< 0.0001 at 1 month,p< 0.05 at 6 months, andp< 0.01 at 1 year). Adjusting for age and other variables reduced but did not reverse the survival differential favoring smokers at 1 month, but adjusting for age alone eliminated the differences in mortality rates at 6 and 12 months. We conclude that while smoking is a risk factor for cardiovascular disease and may contribute to the occurrence of AMI at a younger age, smoking at the time of AMI does not appear to be an independent predictor of death during the first year after AMI.