Shanghai Institute of Health Sciences, Shanghai, China.
J Vasc Surg. 2010 Mar;51(3):673-8. doi: 10.1016/j.jvs.2009.09.024.
Smoking is a major risk factor for peripheral arterial disease (PAD), and PAD is associated with all-cause and cardiovascular disease (CVD) mortality. The objective of this study was to determine the combined effects of smoking and PAD on all-cause and CVD mortality.
A total of 1979 males 35 years of age or older were enrolled from eight university-affiliated hospitals in Beijing and Shanghai in 2004, with both smoking status and PAD diagnosis obtained, 1712 of them had complete follow-up data. Mortality data were obtained from all participants between December 2007 and February 2008. Cox proportional hazards models were used to evaluate relative risks (RRs) of all-cause mortality and CVD mortality among different groups.
At baseline, the average age of participants was 66.98-years-old (SD = 11.57), prevalence of PAD was 24.0% and 65.4% smoked cigarettes. During the 3-year follow-up, all-cause cumulative mortality rates were 27.9% (PAD/smoker), 26.3% (PAD/nonsmoker), 14.1% (no PAD/smoker), and 14.4% (no PAD/nonsmoker) (P < .001), and CVD cumulative mortality rates were 17.8%, 14.9%, 8.1%, and 7.3%, respectively (P < .001). Compared with the no PAD/nonsmoker subjects, adjusted RR from all-cause mortality in the groups of both PAD/smoker, PAD/nonsmoker, and no PAD/smoker were 1.88 (95% confidence interval [CI], 1.34-2.64), 1.37 (95% CI, 0.85-2.23), and 1.08 (95% CI, 0.79-1.49), respectively. The adjusted RR from CVD mortality was 2.12 (95% CI, 1.37-3.28), 1.55 (95% CI, 0.84-2.86), and 1.13 (95% CI, 0.74-1.71), respectively.
PAD is a major determinant of mortality. Smoking did not contribute to mortality in this study. Further research is needed.
吸烟是外周动脉疾病（PAD）的主要危险因素，而 PAD 与全因和心血管疾病（CVD）死亡率相关。本研究旨在确定吸烟和 PAD 对全因和 CVD 死亡率的综合影响。
2004 年，从北京和上海的八所大学附属医院共招募了 1979 名 35 岁及以上的男性，同时获得了吸烟状况和 PAD 诊断，其中 1712 名有完整的随访数据。2007 年 12 月至 2008 年 2 月期间，从所有参与者处获得了死亡率数据。使用 Cox 比例风险模型评估不同组之间全因死亡率和 CVD 死亡率的相对风险（RR）。
在基线时，参与者的平均年龄为 66.98 岁（SD = 11.57），PAD 的患病率为 24.0%，65.4%的人吸烟。在 3 年的随访期间，全因累积死亡率分别为 27.9%（PAD/吸烟者）、26.3%（PAD/非吸烟者）、14.1%（无 PAD/吸烟者）和 14.4%（无 PAD/非吸烟者）（P <.001），CVD 累积死亡率分别为 17.8%、14.9%、8.1%和 7.3%（P <.001）。与无 PAD/非吸烟者相比，PAD/吸烟者、PAD/非吸烟者和无 PAD/吸烟者的全因死亡率的调整 RR 分别为 1.88（95%置信区间[CI]，1.34-2.64）、1.37（95%CI，0.85-2.23）和 1.08（95%CI，0.79-1.49）。CVD 死亡率的调整 RR 分别为 2.12（95%CI，1.37-3.28）、1.55（95%CI，0.84-2.86）和 1.13（95%CI，0.74-1.71）。
PAD 是死亡率的主要决定因素。在本研究中，吸烟并没有增加死亡率。需要进一步研究。
