University of Alabama at Birmingham, 1530 3rd Avenue South, CH-19, Suite 219, Birmingham, AL 35294-2041, USA.
Arch Gerontol Geriatr. 2012 Jul-Aug;55(1):85-90. doi: 10.1016/j.archger.2011.05.027. Epub 2011 Jul 6.
Tobacco smoking is a risk factor for atrial fibrillation (AF), but little is known about the impact of smoking in patients with AF. Of the 4060 patients with recurrent AF in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial, 496 (12%) reported having smoked during the past two years. Propensity scores for smoking were estimated for each of the 4060 patients using a multivariable logistic regression model and were used to assemble a matched cohort of 487 pairs of smokers and nonsmokers, who were balanced on 46 baseline characteristics. Cox and logistic regression models were used to estimate the associations of smoking with all-cause mortality and all-cause hospitalization, respectively, during over 5 years of follow-up. Matched participants had a mean age of 70 ± 9 years (± S.D.), 39% were women, and 11% were non-white. All-cause mortality occurred in 21% and 16% of matched smokers and nonsmokers, respectively (when smokers were compared with nonsmokers, hazard ratio=HR=1.35; 95% confidence interval=95%CI=1.01-1.81; p=0.046). Unadjusted, multivariable-adjusted and propensity-adjusted HR (95% CI) for all-cause mortality associated with smoking in the pre-match cohort were: 1.40 (1.13-1.72; p=0.002), 1.45 (1.16-1.81; p=0.001), and 1.39 (1.12-1.74; p=0.003), respectively. Smoking had no association with all-cause hospitalization (when smokers were compared with nonsmokers, odds ratio=OR=1.21; 95%CI=0.94-1.57, p=0.146). Among patients with AF, a recent history of smoking was associated with an increased risk of all-cause mortality, but had no association with all-cause hospitalization.
吸烟是心房颤动（AF）的一个危险因素，但对于 AF 患者中吸烟的影响知之甚少。在心房颤动节律管理随访研究（AFFIRM）试验中，4060 例复发性 AF 患者中有 496 例（12%）报告在过去两年中吸烟。使用多变量逻辑回归模型为 4060 例患者中的每一位估计吸烟倾向得分，并使用该得分来组装一个匹配的 487 对吸烟者和不吸烟者队列，该队列在 46 项基线特征上平衡。使用 Cox 和逻辑回归模型分别估计吸烟与 5 年以上随访期间全因死亡率和全因住院率的关系。匹配参与者的平均年龄为 70 ± 9 岁（±标准差），39%为女性，11%为非白人。全因死亡率分别在匹配的吸烟者和不吸烟者中发生在 21%和 16%（当与不吸烟者相比时，吸烟者的危险比（HR）=1.35；95%置信区间（95%CI）=1.01-1.81；p=0.046）。在未调整、多变量调整和倾向得分调整的情况下，与匹配前队列中吸烟相关的全因死亡率的 HR（95%CI）分别为：1.40（1.13-1.72；p=0.002）、1.45（1.16-1.81；p=0.001）和 1.39（1.12-1.74；p=0.003）。吸烟与全因住院率无关（与不吸烟者相比，吸烟者的比值比（OR）=1.21；95%CI=0.94-1.57，p=0.146）。在 AF 患者中，近期吸烟史与全因死亡率增加相关，但与全因住院率无关。
