Department of Cardiovascular Surgery, National Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167A Beilishi Rd, Xi Cheng District, Beijing, 100037, People's Republic of China.
Department of Special Medical Treatment Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, People's Republic of China.
BMC Cardiovasc Disord. 2021 May 12;21(1):236. doi: 10.1186/s12872-021-02056-9.
Data on the effect of smoking on In-hospital outcome in patients with left ventricular dysfunction undergoing coronary artery bypass graft (CABG) surgery are limited. We sought to determine the influence of smoking on CABG patients with left ventricular dysfunction.
A retrospective study was conducted using data from the China Heart Failure Surgery Registry database. Eligible patients with left ventricular ejection fraction less than 50% underwent isolated CABGS were included. In addition to the use of multivariate regression models, a 1-1 propensity scores matched analysis was performed. Our study (n = 6531) consisted of 3635 smokers and 2896 non-smokers. Smokers were further divided into ex-smokers (n = 2373) and current smokers (n = 1262).
The overall in-hospital morality was 3.9%. Interestingly, current smokers have lower in-hospital mortality than non-smokers [2.3% vs 4.9%; adjusted odds ratio (OR) 0.612 (95% CI 0.395-0.947) ]. No difference was detected in mortality between ex-smokers and non-smokers [3.6% vs 4.9%; adjusted OR 0.974 (0.715-1.327)]. No significant differences in other clinical end points were observed. Results of propensity-matched analyses were broadly consistent.
It is paradoxically that current smokers had lower in-hospital mortality than non-smokers. Future studies should be performed to further understand the biological mechanisms that may explain this 'smoker's paradox' phenomenon.
关于吸烟对行冠状动脉旁路移植术（CABG）的左心室功能障碍患者住院结局影响的数据有限。我们旨在确定吸烟对左心室功能障碍的 CABG 患者的影响。
本研究采用中国心力衰竭外科注册数据库的数据进行回顾性研究。纳入接受单纯 CABGS 且左心室射血分数小于 50%的患者。除了使用多变量回归模型外，还进行了 1:1 倾向评分匹配分析。我们的研究（n=6531）包括 3635 名吸烟者和 2896 名非吸烟者。吸烟者进一步分为戒烟者（n=2373）和当前吸烟者（n=1262）。
总体住院死亡率为 3.9%。有趣的是，当前吸烟者的住院死亡率低于非吸烟者[2.3%比 4.9%；调整后的比值比（OR）0.612（95%CI 0.395-0.947）]。与非吸烟者相比，戒烟者的死亡率没有差异[3.6%比 4.9%；调整后的 OR 0.974（0.715-1.327）]。其他临床终点没有显著差异。倾向评分匹配分析的结果基本一致。
当前吸烟者的住院死亡率低于非吸烟者，这令人感到矛盾。未来应开展进一步研究以更好地了解可能解释这种“吸烟者悖论”现象的生物学机制。
