Toluey Mehdi, Ghaffari Samad, Tajlil Arezou, Nasiri Babak, Rostami Ali
Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
J Cardiovasc Thorac Res. 2019;11(3):209-215. doi: 10.15171/jcvtr.2019.35. Epub 2019 Aug 1.
Smoking, which is a major modifiable risk factor for coronary artery diseases, affects cardiovascular system with different mechanisms. We designed this study to investigate the association of smoking with location of ST-segment elevation myocardial infarction (STEMI), and short-term outcomes during hospitalization. In 1017 consecutive patients with anterior/inferior STEMI, comprehensive demographic, biochemical data, as well as clinical complications and mortality rate, were recorded. Patients were allocated into two groups based on smoking status and compared regarding the location of myocardial infarction, the emergence of clinical complications and in-hospital mortality in univariate and multivariate logistic regression analysis. Among 1017 patients, 300 patients (29.5%) were smoker and 717 patients (70.5 %) were non-smoker. Smokers were significantly younger and had lower prevalence of diabetes, hyperlipidemia and hypertension. Inferior myocardial infarction was considerably more common in smokers than in non-smokers (45.7% vs. 36%, = 0.001). Heart failure was developed more commonly in non-smokers (33.9% vs. 20%, = 0.001). In-hospital mortality was significantly lower in smokers (6.7% vs. 17.3%, = 0.001). After adjustment for confounding variables, smoking was independently associated with inferior myocardial infarction and lower heart failure [odds ratio: 1.44 (1.06-1.96), = 0.01 and odds ratio: 0.61 (0.40-0.92), = 0.02, respectively]. However, in-hospital mortality was not associated with smoking after adjustment for other factors [odds ratio: 0.69 (0.36-1.31), = 0.2]. Smoking is independently associated with inferior myocardial infarction. Although smokers had lower incidence of heart failure, in-hospital mortality was not different after adjustment for other factors.
吸烟是冠状动脉疾病的一个主要可改变风险因素，通过不同机制影响心血管系统。我们设计本研究以调查吸烟与ST段抬高型心肌梗死（STEMI）部位及住院期间短期结局的关联。在1017例连续性前壁/下壁STEMI患者中，记录了全面的人口统计学、生化数据以及临床并发症和死亡率。根据吸烟状况将患者分为两组，并在单因素和多因素逻辑回归分析中比较心肌梗死部位、临床并发症的出现情况及住院死亡率。在1017例患者中，300例（29.5%）为吸烟者，717例（70.5%）为非吸烟者。吸烟者明显更年轻，糖尿病、高脂血症和高血压的患病率更低。下壁心肌梗死在吸烟者中比在非吸烟者中更为常见（45.7%对36%，P = 0.001）。心力衰竭在非吸烟者中更常见（33.9%对20%，P = 0.001）。吸烟者的住院死亡率显著更低（6.7%对17.3%，P = 0.001）。在对混杂变量进行校正后，吸烟与下壁心肌梗死及较低的心力衰竭独立相关[比值比：1.44（1.06 - 1.96），P = 0.01和比值比：0.61（0.40 - 0.92），P = 0.02，分别]。然而，在对其他因素进行校正后，住院死亡率与吸烟无关[比值比：0.69（0.36 - 1.31），P = 0.2]。吸烟与下壁心肌梗死独立相关。尽管吸烟者心力衰竭的发生率较低，但在对其他因素进行校正后，住院死亡率并无差异。
