Hamrah Mohammad Shoaib, Suzuki Susumu, Ishii Hideki, Shibata Yohei, Tatami Yosuke, Osugi Naohiro, Ota Tomoyuki, Kawamura Yoshihiro, Tanaka Akihito, Aso Hiromichi, Takeshita Kyosuke, Sakamoto Junichi, Hasegawa Yoshinori, Murohara Toyoaki
Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Respiration. 2015;89(4):322-8. doi: 10.1159/000375313. Epub 2015 Mar 17.
Both airflow limitation and smoking are established cardiovascular risk factors. However, their interaction as risk factors for the development of atherosclerosis in coronary artery disease patients remains unclear.
To evaluate the effect of the interaction between airflow limitation and smoking status on the severity of carotid atherosclerosis.
We categorized the 234 enrolled patients with coronary artery disease into four groups: never-smokers with normal pulmonary function (group A), never-smokers with airflow limitation (group B), ever-smokers with normal pulmonary function (group C), and ever-smokers with airflow limitation (group D).
The prevalence of airflow limitation in the enrolled patients was 23.1% (ever-smokers: 15.8%, never-smokers: 7.3%). The prevalence of severe carotid atherosclerosis was 28.2, 29.4, 41.3, and 45.9%, respectively, in the four groups (group D vs. group A, p = 0.035). Even after multivariate adjusting for confounding factors, ever-smokers with airflow limitation were independently associated with severe carotid atherosclerosis (odds ratio 2.89, 95% confidence interval, 1.19-7.00, p = 0.019).
Ever-smokers with airflow limitation were significantly associated with severe carotid atherosclerosis among patients with coronary artery disease. These findings also provide additional insight into the correlation between airflow limitation and poor cardiovascular clinical outcomes.
气流受限和吸烟均为公认的心血管危险因素。然而，它们作为冠状动脉疾病患者动脉粥样硬化发生的危险因素之间的相互作用仍不清楚。
评估气流受限与吸烟状况之间的相互作用对颈动脉粥样硬化严重程度的影响。
我们将234例入选的冠状动脉疾病患者分为四组：肺功能正常的从不吸烟者（A组）、气流受限的从不吸烟者（B组）、肺功能正常的曾经吸烟者（C组）和气流受限的曾经吸烟者（D组）。
入选患者中气流受限的患病率为23.1%（曾经吸烟者：15.8%，从不吸烟者：7.3%）。四组中重度颈动脉粥样硬化的患病率分别为28.2%、29.4%、41.3%和45.9%（D组与A组相比，p = 0.035）。即使在对混杂因素进行多变量调整后，气流受限的曾经吸烟者仍与重度颈动脉粥样硬化独立相关（比值比2.89，95%置信区间，1.19 - 7.00，p = 0.019）。
气流受限的曾经吸烟者与冠状动脉疾病患者的重度颈动脉粥样硬化显著相关。这些发现也为气流受限与不良心血管临床结局之间的相关性提供了更多见解。
