Department of Internal Medicine, Istituti Ospitalieri di Cremona, 26100 Cremona, Italy.
Department of Internal Medicine, Hospital Germans Trias i Pujol, Universidad Católica de Murcia, 08016 Barcelona, Spain.
Medicina (Kaunas). 2022 Feb 15;58(2):295. doi: 10.3390/medicina58020295.
: The influence of smoking habits on mortality, VTE recurrence, and major bleeding in patients receiving anticoagulant therapy for venous thromboembolism (VTE) has not been consistently evaluated. : We used data from the RIETE (Registro Enfermedad TromboEmbólica) registry to compare mortality, VTE recurrence, and major bleeding risk in smoking versus non-smoking patients with acute VTE. : 50,881 patients (43,426 non-smoking and 7455 smoking patients) were included. After a median follow-up of 8.8 months, 7110 patients died (fatal PE 292 and fatal bleeding 281), 3243 presented VTE recurrence, and 1579 had major bleeding. At multivariate analysis, smoking behavior was associated with a higher hazard of death, (HR: 1.28; 95% CI: 1.19-1.40). The risk of VTE recurrence was marginally increased in smoking patients compared to non-smoking patients (1.14; 95% CI: 1.02-1.27). Major bleeding did not differ in smoking and non-smoking patients (1.15; 95% CI: 0.96-1.38). The presence of cancer did not appear to influence the association between smoking habits and death (HR: 1.34; 95% CI: 1.22-1.47 in cancer patients and HR: 1.23; 95% CI: 1.04, 1.45 in non-cancer patients, respectively) : the risk of death after an acute episode of VTE appeared to be higher in smoking than in non-smoking patients and this risk is higher between patients presenting PE at the onset of symptoms.
：吸烟习惯对接受抗凝治疗的静脉血栓栓塞症（VTE）患者的死亡率、VTE 复发和大出血的影响尚未得到一致评估。
：我们使用 RIETE（血栓栓塞疾病登记处）登记处的数据，比较了急性 VTE 吸烟和不吸烟患者的死亡率、VTE 复发和大出血风险。
：共纳入 50881 例患者（43426 例不吸烟者和 7455 例吸烟者）。中位随访 8.8 个月后，7110 例患者死亡（致死性 PE 292 例，致死性出血 281 例），3243 例发生 VTE 复发，1579 例发生大出血。多变量分析显示，吸烟行为与死亡风险增加相关（HR：1.28；95%CI：1.19-1.40）。与不吸烟者相比，吸烟者发生 VTE 复发的风险略有增加（1.14；95%CI：1.02-1.27）。吸烟者与非吸烟者的大出血发生率无差异（1.15；95%CI：0.96-1.38）。癌症的存在似乎并未影响吸烟习惯与死亡之间的关联（癌症患者的 HR：1.34；95%CI：1.22-1.47 和非癌症患者的 HR：1.23；95%CI：1.04，1.45）。急性 VTE 发作后，吸烟者的死亡风险似乎高于不吸烟者，而在首发症状为 PE 的患者中，这种风险更高。
