Department of Neurology, Beijing Hepingli Hospital, No.18 North Street Hepingli, Dongcheng District, Beijing, 100013, China.
Department of Physiology and Pathophysiology, Key Laboratory of Molecular Cardiovascular Sciences, Ministry of Education, and Beijing Key Laboratory of Cardiovascular Receptors Research, Peking University School of Basic Medical Sciences, No.38 Xueyuan Road, Haidian District, Beijing, 100191, China.
J Neurol. 2021 Jun;268(6):2042-2054. doi: 10.1007/s00415-019-09596-3. Epub 2019 Oct 29.
Ischemic stroke (IS) is a common cause of death from vascular diseases. Studies have found that smoking increases the risk of ischemic stroke, but the association of smoking with the outcome of IS remains unclear. This meta-analysis aims to investigate the effect of smoking on the prognosis of IS.
We searched four electronic databases including PubMed, EMBASE, Cochrane library and Web of science for papers, published before January 2019. In this meta-analysis, Review Manager 5.3 software was used to calculate for the pooled estimate effect, as well as the inverse-variance method for pooled mean difference (MD) and odds ratio (OR) of incidence in two groups of population.
A total of 14,789 citations were identified during the literature search, 21 studies were included in the meta-analyses after screening. The full-adjusted OR of poor prognostic outcome in smoking and nonsmoking patients with stroke was pooled as 0.96 (95% CI 0.77-1.21), suggested that smoking or not has no impact on prognosis of IS. The pooled MD of onset age between smoking and nonsmoking IS patients was - 10.05 (- 12.91, - 7.19), indicated that smoking causes first onset of IS to occur 10 years earlier.
This meta-analysis showed that smoking was not a protective factor for poor prognosis of IS. Smoking patients with IS are 10 years younger than nonsmoking patients at time of the first onset of stroke.
缺血性脑卒中（IS）是血管疾病导致死亡的常见原因。研究发现，吸烟会增加缺血性脑卒中的风险，但吸烟与 IS 结局的相关性尚不清楚。本荟萃分析旨在探讨吸烟对 IS 预后的影响。
我们检索了 PubMed、EMBASE、Cochrane 图书馆和 Web of Science 四个电子数据库，检索时间截至 2019 年 1 月。本荟萃分析采用 Review Manager 5.3 软件计算汇总估计效应，以及两组人群发病率的汇总均数差（MD）和比值比（OR）的逆方差法。
文献检索共识别出 14789 条引文，筛选后有 21 项研究纳入荟萃分析。对吸烟和不吸烟的脑卒中患者预后不良结局的完全校正 OR 进行汇总为 0.96（95% CI 0.77-1.21），表明吸烟与否对 IS 的预后没有影响。吸烟和不吸烟的 IS 患者发病年龄的汇总 MD 为-10.05（-12.91，-7.19），表明吸烟导致 IS 首次发病提前 10 年。
本荟萃分析表明，吸烟不是 IS 预后不良的保护因素。吸烟的 IS 患者首次发生卒中的年龄比不吸烟的患者年轻 10 岁。
