戒烟与纵向队列研究中的房颤事件。
Smoking Cessation and Incident Atrial Fibrillation in a Longitudinal Cohort.
机构信息
Department of Medicine, Division of Cardiology, University of California-San Francisco, San Francisco, California, USA.
Department of Epidemiology and Biostatistics, University of California-San Francisco, San Francisco, California, USA.
出版信息
JACC Clin Electrophysiol. 2024 Oct;10(10):2198-2206. doi: 10.1016/j.jacep.2024.06.019. Epub 2024 Sep 11.
BACKGROUND
Although smoking heightens the risk of AF, it remains unknown if that risk is amenable to modification after smoking cessation.
OBJECTIVES
This study sought to evaluate the association between smoking cessation and atrial fibrillation (AF) risk in a large longitudinal cohort.
METHODS
After excluding those with prevalent AF and no history of smoking at baseline, we evaluated 146,772 UK Biobank participants with serial smoking assessments. We compared AF risk between former smokers at baseline and those who quit smoking during the study to current smokers. Incident AF was ascertained from outpatient and inpatient encounters and identified using International Classification of Diseases codes. Cox models were used to compare the risk of incident AF among current and former smokers as well as those who quit smoking during the study while controlling for age, sex, race, body mass index, education, cardiovascular comorbidities, alcohol use, and pack-years.
RESULTS
Among the 146,772 participants (48.3% female; age: 57.3 ± 7.9 years), 37,377 (25.5%) currently smoked; 105,429 (72.0%) were former smokers; and 3,966 (2.7%) quit smoking during the study. Over a mean 12.7 ± 2.0 years of follow-up, 11,214 (7.6%) participants developed AF. Compared to current smokers, the adjusted risk of AF was 13% lower in former smokers (HR: 0.87; 95% CI: 0.83-0.91) and 18% lower in those who quit smoking during the study (HR: 0.82; 95% CI: 0.70-0.95).
CONCLUSIONS
Compared to those who continue to smoke, smoking cessation was associated with a lower risk of AF.
背景
尽管吸烟会增加房颤（AF）的风险，但目前尚不清楚戒烟后这种风险是否可以降低。
目的
本研究旨在评估在一个大型纵向队列中，戒烟与房颤风险之间的关系。
方法
在排除了基线时患有房颤且无吸烟史的患者后，我们评估了英国生物银行 146772 名有连续吸烟评估的参与者。我们比较了基线时的戒烟者和在研究期间戒烟者与当前吸烟者之间的房颤风险。通过门诊和住院记录来确定房颤的发生，并使用国际疾病分类代码进行识别。使用 Cox 模型比较了当前吸烟者、戒烟者和研究期间戒烟者的房颤发生风险，同时控制了年龄、性别、种族、体重指数、教育程度、心血管合并症、饮酒量和吸烟包年数。
结果
在 146772 名参与者中（48.3%为女性；年龄：57.3±7.9 岁），37377 名（25.5%）目前吸烟；105429 名（72.0%）为曾经吸烟者；3966 名（2.7%）在研究期间戒烟。在平均 12.7±2.0 年的随访期间，11214 名（7.6%）参与者发生了房颤。与当前吸烟者相比，曾经吸烟者的房颤风险降低了 13%（HR：0.87；95%CI：0.83-0.91），在研究期间戒烟者的房颤风险降低了 18%（HR：0.82；95%CI：0.70-0.95）。
结论
与继续吸烟者相比，戒烟与房颤风险降低相关。
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