Department of Cardiology, University of Chicago Medical Center, Chicago, Illinois.
Second Department of Internal Medicine, University of Toyama, Toyama, Japan.
J Card Surg. 2020 Nov;35(11):2913-2919. doi: 10.1111/jocs.14921. Epub 2020 Aug 2.
Active smoking is associated with worse clinical outcomes following left ventricular assist device (LVAD) implantation. However, the effect of sex differences in conjunction with smoking status remains uninvestigated.
Consecutive patients who underwent LVAD implantation between January 2013 and September 2018 were included. Clinical outcomes were retrospectively compared between the current smokers and never smokers among male cohorts and female cohorts separately.
About 130 patients, with a median age of 56 years, were included. Among the male cohort (N = 85), the current smokers (N = 25/85) had a higher total readmission rate than the never smokers (N = 60/85) with an adjusted incidence rate ratio of 2.38 (95% confidence interval, 1.16-3.85, P = .014), dominantly due to higher rates of gastrointestinal bleeding, stroke, and hemolysis. Among the female cohorts (N = 45), never smokers (N = 36/45) had a statistically comparable total readmission rate (2.80 vs 2.50 events per year; P = .37) compared with current smokers (N = 9/45).
Among male patients with LVAD, active smoking was associated with higher rates of adverse events. Female patients with LVAD had a high rate of adverse events irrespective of smoking status. Gender-specific therapeutic approaches might be required to prevent LVAD-related comorbidities.
与左心室辅助装置 (LVAD) 植入后吸烟状况相关的不良临床结局。然而，吸烟状况与性别差异相结合的影响仍未得到调查。
纳入 2013 年 1 月至 2018 年 9 月连续接受 LVAD 植入的患者。分别在男性队列和女性队列中，回顾性比较当前吸烟者和从不吸烟者之间的临床结局。
大约 130 名患者，中位年龄为 56 岁，包括在内。在男性队列（N=85）中，当前吸烟者（N=25/85）的总再入院率高于从不吸烟者（N=60/85），调整后的发病率比为 2.38（95%置信区间，1.16-3.85，P=0.014），主要是由于胃肠道出血、中风和溶血的发生率较高。在女性队列（N=45）中，从不吸烟者（N=36/45）的总再入院率与当前吸烟者（N=9/45）相比具有统计学可比性（2.80 与 2.50 次/年；P=0.37）。
在男性 LVAD 患者中，主动吸烟与更高的不良事件发生率相关。无论吸烟状况如何，女性 LVAD 患者都有很高的不良事件发生率。可能需要针对特定性别的治疗方法来预防 LVAD 相关的合并症。
