与冠心病患者戒烟相关的因素：EuroAspire IV 调查德国亚组的队列分析。
Factors associated with smoking cessation in patients with coronary heart disease: a cohort analysis of the German subset of EuroAspire IV survey.
机构信息
Comprehensive Heart Failure Center, University and University Hospital Würzburg, Am Schwarzenberg 15, Haus A15, D-97078, Würzburg, Germany.
Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany.
出版信息
BMC Cardiovasc Disord. 2020 Mar 30;20(1):152. doi: 10.1186/s12872-020-01429-w.
BACKGROUND
Tobacco smoking is one of the most important risk factors of coronary heart disease (CHD). Hence, smoking cessation is considered pivotal in the prevention of CHD. The current study aimed to evaluate smoking cessation patterns and determine factors associated with smoking cessation in patients with established CHD.
METHODS
The fourth European Survey of Cardiovascular Disease Prevention and Diabetes investigated quality of CHD care in 24 countries across Europe in 2012/13. In the German subset, smoking cessation patterns and clinical characteristics were repetitively assessed a) during index event due to CHD by medical record abstraction, b) as part of a face-to-face interview 6 to 36 months after the index event (i.e. baseline visit), and c) by telephone-based follow-up interview two years after the baseline visit. Logistic regression analysis was performed to search for factors determining smoking status at the time of the telephone interview.
RESULTS
Out of 469 participants available for follow-up, 104 (22.2%) had been classified as current smokers at the index event. Of those, 65 patients (62.5%) had quit smoking at the time of the telephone interview, i.e., after a median observation period of 3.5 years (quartiles 3.0, 4.1). Depressed mood at baseline visit and higher education level were less prevalent amongst quitters vs non-quitters (17.2% vs 35.9%, p = 0.03 and 15.4% vs 33.3%, p = 0.03), cardiac rehabilitation programs were more frequently attended by quitters (83.1% vs 48.7%, p < 0.001), and there was a trend for a higher prevalence of diabetes at baseline visit in quitters (37.5% vs 20.5%, p = 0.07). In the final multivariable model, cardiac rehabilitation was associated with smoking cessation (OR 5.19; 95%CI 1.87 to 14.46; p = 0.002).
DISCUSSION
Attending a cardiac rehabilitation program after a cardiovascular event was associated with smoking cessation supporting its use as a platform for smoking cessation counseling and relapse prevention.
背景
吸烟是冠心病（CHD）最重要的危险因素之一。因此，戒烟被认为是预防 CHD 的关键。本研究旨在评估已确诊 CHD 患者的戒烟模式，并确定与戒烟相关的因素。
方法
第四次欧洲心血管疾病预防和糖尿病调查于 2012/13 年在欧洲 24 个国家调查了 CHD 护理质量。在德国子样本中，通过病历摘录在 CHD 首发事件期间反复评估戒烟模式和临床特征，a）；在首发事件后 6 至 36 个月（即基线访视）进行面对面访谈，b）；通过基线访视两年后的电话随访访谈，c）。采用逻辑回归分析寻找决定电话访谈时吸烟状况的因素。
结果
在可进行随访的 469 名参与者中，有 104 名（22.2%）在首发事件时被归类为当前吸烟者。其中，65 名患者（62.5%）在电话访谈时已戒烟，即中位观察期为 3.5 年后（四分位数 3.0，4.1）。与未戒烟者相比，戒烟者在基线访视时的抑郁情绪（17.2%比 35.9%，p=0.03）和较高的教育水平（15.4%比 33.3%，p=0.03）更为少见，戒烟者更常参加心脏康复计划（83.1%比 48.7%，p<0.001），且在基线访视时，戒烟者的糖尿病患病率有增高趋势（37.5%比 20.5%，p=0.07）。在最终的多变量模型中，心脏康复与戒烟相关（OR 5.19；95%CI 1.87 至 14.46；p=0.002）。
讨论
在心血管事件后参加心脏康复计划与戒烟相关，支持将其作为戒烟咨询和复发预防的平台。
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