Son Youn-Jung, Lee Hyeon-Ju
Red Cross College of Nursing, Chung-Ang University, Seoul, Republic of Korea.
Department of Nursing, Tongmyong University, Busan, Republic of Korea.
Tob Induc Dis. 2020 Jan 20;18:05. doi: 10.18332/tid/116411. eCollection 2020.
Heart failure (HF) is associated with increased mortality worldwide. Adverse health outcomes in HF are commonly attributed to poor adherence to self-care, including smoking cessation. Smoking is the major modifiable risk factor for HF. Patients have been observed to continue smoking even after diagnosis with HF. Despite the possible association between persistent smoking and adverse health outcomes among HF populations, no consensus has been reached. We aimed to review the literature to determine the association between smoking status after HF diagnosis and adverse health outcomes.
A systematic literature search was performed in PubMed, PsycINFO, Web of Science, and Embase. Hand searching was also performed. In total, 9 articles (n=70461) were included in the review for meta-analysis, including seven cohort studies and two cross-sectional studies. Quality was assessed using the modified version of the Newcastle-Ottawa Scale.
Approximately 16% of HF patients continued smoking after HF diagnosis. Persistent smoking increased the hazard ratio (HR) of mortality by 38.4% (HR=1.384; 95% CI: 1.139-1.681) and readmission by 44.8% (HR=1.448; 95% CI: 1.086-1.930). Our review also found that persistent smoking was associated with poor health status, ventricular tachycardia, and arterial stiffness.
This review highlights the importance of assessment for any history of smoking before and after HF diagnosis. There is a need for smoking cessation programs to be established as crucial components of care for patients with HF. More studies are needed to investigate the possible mechanisms underlying relations among smoking patterns and health consequences.
心力衰竭（HF）在全球范围内与死亡率增加相关。HF患者不良的健康结局通常归因于自我护理依从性差，包括戒烟。吸烟是HF的主要可改变风险因素。即使在被诊断为HF后，仍观察到患者继续吸烟。尽管在HF人群中持续吸烟与不良健康结局之间可能存在关联，但尚未达成共识。我们旨在回顾文献，以确定HF诊断后吸烟状况与不良健康结局之间的关联。
在PubMed、PsycINFO、Web of Science和Embase中进行了系统的文献检索。还进行了手工检索。总共9篇文章（n = 70461）被纳入综述以进行荟萃分析，包括7项队列研究和2项横断面研究。使用纽卡斯尔-渥太华量表的修改版评估质量。
约16%的HF患者在HF诊断后继续吸烟。持续吸烟使死亡风险比（HR）增加38.4%（HR = 1.384；95%CI：1.139 - 1.681），再入院风险比增加44.8%（HR = 1.448；95%CI：1.086 - 1.930）。我们的综述还发现，持续吸烟与健康状况不佳、室性心动过速和动脉僵硬度有关。
本综述强调了在HF诊断前后评估吸烟史的重要性。需要将戒烟计划作为HF患者护理的关键组成部分来建立。需要更多的研究来调查吸烟模式与健康后果之间关系的潜在机制。
