Tzou Wendy, Vitcenda Mark, McBride Patrick
University of Wisconsin Medical School, Madison 53792-0001, USA.
J Cardiopulm Rehabil. 2004 Mar-Apr;24(2):94-9. doi: 10.1097/00008483-200403000-00005.
Smoking cessation is a priority for patients with cardiovascular disease (CVD). Smoking correlates and predictors were studied after CVD events in outpatient cardiac rehabilitation (OCR) with the aim of characterizing CVD patients at high risk for continued smoking.
Subjects hospitalized during 1996-2002 for CVD events were referred to OCR. Smoking prevalence was compared among OCR and non-OCR patients. Age, sex, body mass index, and working status (independent variables) were analyzed univariately among OCR and non-OCR smoking groups. Lipoproteins, CVD events, and health self-confidence (independent variables) were compared among OCR smoking groups. Multivariate analysis of OCR smoking groups was performed to elicit potential smoking predictors.
Among the 472 OCR and 152 non-OCR patients, non-OCR status (30.5% vs 13.6%, P<.0002) and age younger than 55 years (P<.0002) correlated with current smoking. Male sex (19.4% vs 13%; P=.06) approached significant risk. For OCR patients, younger age (odds ratio [OR], 0.95; P=.003) and angina (OR, 13.7; P=.03), most strongly predicted current smoking. Among all the patients, more current smokers (37%) than former smokers (16.5%) returned to work (P=.0004). More current smokers (6.5%) were disabled than former smokers (1.4%) and never smokers (2.4%) (P<.0002). In the OCR group, the never smokers mean body mass index was the lowest (27.8 vs 29.1 for former smokers and 30.1 for current smokers (P< or =.006). Current smokers had the highest triglycerides and perceived that cardiac health did not significantly improve with OCR.
Smoking with CVD was higher among non-OCR patients, those younger than 55 years, and those with angina. Current smoking status correlated with high triglycerides, poor health self-confidence, and more disability. Outpatient cardiac rehabilitation programs can identify patients at high risk for continued smoking on the basis of these characteristics and should consider new strategies to encourage their participation in smoking cessation and rehabilitation.
戒烟是心血管疾病（CVD）患者的首要任务。对门诊心脏康复（OCR）中CVD事件后的吸烟相关性及预测因素进行研究，旨在确定持续吸烟高危的CVD患者特征。
将1996 - 2002年因CVD事件住院的患者转诊至OCR。比较OCR患者与非OCR患者的吸烟率。在OCR吸烟组与非OCR吸烟组中，对年龄、性别、体重指数和工作状态（自变量）进行单因素分析。在OCR吸烟组中比较脂蛋白、CVD事件和健康自信心（自变量）。对OCR吸烟组进行多变量分析以找出潜在的吸烟预测因素。
在472例OCR患者和152例非OCR患者中，非OCR状态（30.5%对13.6%，P<0.0002）以及年龄小于55岁（P<0.0002）与当前吸烟相关。男性（19.4%对13%；P = 0.06）接近显著风险。对于OCR患者，年龄较小（比值比[OR]，0.95；P = 0.003）和心绞痛（OR，13.7；P = 0.03）是当前吸烟的最强预测因素。在所有患者中，当前吸烟者恢复工作的比例（37%）高于既往吸烟者（16.5%）（P = 0.0004）。当前吸烟者中残疾的比例（6.5%）高于既往吸烟者（1.4%）和从不吸烟者（2.4%）（P<0.0002）。在OCR组中，从不吸烟者的平均体重指数最低（27.8，既往吸烟者为29.1，当前吸烟者为30.1（P≤0.006）。当前吸烟者的甘油三酯水平最高，且认为心脏健康在OCR后没有显著改善。
非OCR患者、年龄小于55岁的患者以及有心绞痛的患者中，CVD合并吸烟的情况更为常见。当前吸烟状态与高甘油三酯、健康自信心差和更多残疾相关。门诊心脏康复项目可根据这些特征识别持续吸烟高危患者，并应考虑采用新策略鼓励他们参与戒烟和康复。
