Gaalema Diann E, Cutler Alexander Y, Higgins Stephen T, Ades Philip A
Vermont Center on Behavior and Health, University of Vermont, USA; Department of Psychiatry, University of Vermont, USA; Department of Psychology, University of Vermont, USA.
Vermont Center on Behavior and Health, University of Vermont, USA; Department of Psychiatry, University of Vermont, USA.
Prev Med. 2015 Nov;80:67-74. doi: 10.1016/j.ypmed.2015.04.009. Epub 2015 Apr 18.
Continued smoking after a cardiac event greatly increases mortality risk. Smoking cessation and participation in cardiac rehabilitation (CR) are effective in reducing morbidity and mortality. However, these two behaviors may interact; those who smoke may be less likely to access or complete CR. This review explores the association between smoking status and CR referral, attendance, and adherence.
A systematic literature search was conducted examining associations between smoking status and CR referral, attendance and completion in peer-reviewed studies published through July 1st, 2014. For inclusion, studies had to report data on outpatient CR referral, attendance or completion rates and smoking status had to be considered as a variable associated with these outcomes.
Fifty-six studies met inclusion criteria. In summary, a history of smoking was associated with an increased likelihood of referral to CR. However, smoking status also predicted not attending CR and was a strong predictor of CR dropout.
Continued smoking after a cardiac event predicts lack of attendance in, and completion of CR. The issue of smoking following a coronary event deserves renewed attention.
心脏事件后持续吸烟会大幅增加死亡风险。戒烟并参与心脏康复（CR）有助于降低发病率和死亡率。然而，这两种行为可能相互影响；吸烟者可能较难获得或完成CR。本综述探讨吸烟状况与CR转诊、就诊率及依从性之间的关联。
进行了一项系统性文献检索，考察截至2014年7月1日发表的同行评议研究中吸烟状况与CR转诊、就诊及完成情况之间的关联。纳入的研究必须报告门诊CR转诊、就诊率或完成率的数据，且吸烟状况必须被视为与这些结果相关的变量。
56项研究符合纳入标准。总体而言，吸烟史与转诊至CR的可能性增加相关。然而，吸烟状况也预示着不会参加CR，并且是CR退出的有力预测因素。
心脏事件后持续吸烟预示着无法参加和完成CR。冠状动脉事件后的吸烟问题值得重新关注。
