1 Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK.
2 Department of Nutrition, Bjørknes University College, Oslo, Norway.
Eur J Prev Cardiol. 2019 Feb;26(3):279-288. doi: 10.1177/2047487318806658. Epub 2018 Oct 18.
We conducted a systematic review and meta-analysis to clarify the association between smoking and the risk of developing heart failure.
PubMed and Embase databases were searched up to 24 July 2018. Prospective studies were included if they reported adjusted relative risk (RR) estimates and 95% confidence intervals (CIs) of heart failure associated with smoking. Summary RRs and 95% CIs were estimated using a random effects model.
Twenty-six studies were included. The summary RR was 1.75 (95% CI: 1.54-1.99, I= 81%, n = 10) for current smokers, 1.16 (95% CI: 1.08-1.24, I= 51%, n = 9) for former smokers, and 1.44 (1.34-1.55, I= 83%, n = 10) for ever smokers compared with never smokers. The summary RR was 1.41 (95% CI: 1.01-1.96, I= 82%, n = 2) per 10 cigarettes per day, 1.11 (95% CI: 1.04-1.18, I= 70%, n = 3) and 1.08 (95% CI: 1.02-1.14, I= 34%, n = 2) per 10 pack-years among ever smokers and former smokers, respectively, and 0.79 (95% CI: 0.63-1.00, I= 96%, n = 2) per 10 years since quitting smoking. The association between smoking cessation and heart failure reached significance at 15 years of smoking cessation, and at 30 years the summary RR was 0.72 (95% CI: 0.57-0.90), only slightly higher than the summary RR for never smokers (0.64 (95% CI: 0.57-0.72)) when compared with current smokers.
Smoking is associated with increased risk of heart failure, but the risk decreases with increasing duration since smoking cessation. Any further studies should investigate the association between number of cigarettes per day, duration, pack-years and time since quitting smoking and risk of heart failure.
我们进行了一项系统评价和荟萃分析，以阐明吸烟与心力衰竭风险之间的关联。
检索了 PubMed 和 Embase 数据库，截至 2018 年 7 月 24 日。如果研究报告了与吸烟相关的心力衰竭的调整后相对风险（RR）估计值和 95％置信区间（CI），则纳入前瞻性研究。使用随机效应模型估算汇总 RR 和 95％CI。
共纳入 26 项研究。与从不吸烟者相比，当前吸烟者的汇总 RR 为 1.75（95％CI：1.54-1.99，I=81％，n=10），曾经吸烟者为 1.16（95％CI：1.08-1.24，I=51％，n=9），而无论吸烟状况如何，吸烟者的 RR 为 1.44（1.34-1.55，I=83％，n=10）。每天每吸 10 支香烟的汇总 RR 为 1.41（95％CI：1.01-1.96，I=82％，n=2），曾经吸烟者和前吸烟者分别为每吸 10 包年 1.11（95％CI：1.04-1.18，I=70％，n=3）和 1.08（95％CI：1.02-1.14，I=34％，n=2），而戒烟后每 10 年的 RR 为 0.79（95％CI：0.63-1.00，I=96％，n=2）。吸烟与心力衰竭之间的关联在戒烟 15 年后达到显著水平，而在 30 年后，汇总 RR 为 0.72（95％CI：0.57-0.90），仅略高于当前吸烟者的汇总 RR（0.64（95％CI：0.57-0.72））与从不吸烟者相比。
吸烟与心力衰竭风险增加有关，但随着戒烟时间的延长，风险会降低。任何进一步的研究都应调查每天吸烟量、吸烟年限、吸烟包年数和戒烟时间与心力衰竭风险之间的关联。
