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Mallah MA, Soomro T, Ali M, Noreen S, Khatoon N, Kafle A, Feng F, Wang W, Naveed M, Zhang Q. Cigarette smoking and air pollution exposure and their effects on cardiovascular diseases. Front Public Health 2023; 11:967047. [PMID: 38045957 PMCID: PMC10691265 DOI: 10.3389/fpubh.2023.967047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 06/26/2023] [Indexed: 12/05/2023] Open
Abstract
Cardiovascular disease (CVD) has no socioeconomic, topographical, or sex limitations as reported by the World Health Organization (WHO). The significant drivers of CVD are cardio-metabolic, behavioral, environmental, and social risk factors. However, some significant risk factors for CVD (e.g., a pitiable diet, tobacco smoking, and a lack of physical activities), have also been linked to an elevated risk of cardiovascular disease. Lifestyles and environmental factors are known key variables in cardiovascular disease. The familiarity with smoke goes along with the contact with the environment: air pollution is considered a source of toxins that contribute to the CVD burden. The incidence of myocardial infarction increases in males and females and may lead to fatal coronary artery disease, as confirmed by epidemiological studies. Lipid modification, inflammation, and vasomotor dysfunction are integral components of atherosclerosis development and advancement. These aspects are essential for the identification of atherosclerosis in clinical investigations. This article aims to show the findings on the influence of CVD on the health of individuals and human populations, as well as possible pathology and their involvement in smoking-related cardiovascular diseases. This review also explains lifestyle and environmental factors that are known to contribute to CVD, with indications suggesting an affiliation between cigarette smoking, air pollution, and CVD.
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Affiliation(s)
| | - Tahmina Soomro
- Department of Sociology, Shah Abdul Latif University, Khairpur, Pakistan
| | - Mukhtiar Ali
- Department of Chemical Engineering, Quaid-e-Awam University of Engineering, Science and Technology, Nawabshah, Sindh, Pakistan
| | - Sobia Noreen
- Department of Pharmaceutics Technology, Institute of Pharmacy, University of Innsbruck, Insbruck, Austria
| | - Nafeesa Khatoon
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Akriti Kafle
- School of Nursing, Zhengzhou University, Zhengzhou, China
| | - Feifei Feng
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Wang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Muhammad Naveed
- Department of Physiology and Pharmacology, College of Medicine and Life Sciences, University of Toledo, Toledo, OH, United States
| | - Qiao Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Kızıltunç E, Şahin YB, Topal S, Düzenli MA, Karakaya E, Aygül N, Topsakal R, Özdemir K, Abacı A. Efeitos do Ato de Fumar na Mortalidade de Longo Prazo após Infarto do Miocárdio por Elevação de ST. Arq Bras Cardiol 2021; 118:24-32. [PMID: 35195205 PMCID: PMC8959056 DOI: 10.36660/abc.20201036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 01/27/2021] [Indexed: 11/18/2022] Open
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Doi SA, Islam N, Sulaiman K, Alsheikh-Ali AA, Singh R, Al-Qahtani A, Asaad N, AlHabib KF, Al-Zakwani I, Al-Jarallah M, AlMahmeed W, Bulbanat B, Bazargani N, Amin H, Al-Motarreb A, AlFaleh H, Panduranga P, Shehab A, Al Suwaidi J, Salam AM. Demystifying Smoker's Paradox: A Propensity Score-Weighted Analysis in Patients Hospitalized With Acute Heart Failure. J Am Heart Assoc 2019; 8:e013056. [PMID: 31779564 PMCID: PMC6912958 DOI: 10.1161/jaha.119.013056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Background Smoker's paradox has been observed with several vascular disorders, yet there are limited data in patients with acute heart failure (HF). We examined the effects of smoking in patients with acute HF using data from a large multicenter registry. The objective was to determine if the design and analytic approach could explain the smoker's paradox in acute HF mortality. Methods and Results The data were sourced from the acute HF registry (Gulf CARE [Gulf Acute Heart Failure Registry]), a multicenter registry that recruited patients over 10 months admitted with a diagnosis of acute HF from 47 hospitals in 7 Middle Eastern countries. The association between smoking and mortality (in hospital) was examined using covariate adjustment, making use of mortality risk factors. A parallel analysis was performed using covariate balancing through propensity scores. Of 5005 patients hospitalized with acute HF, 1103 (22%) were current smokers. The in-hospital mortality rates were significantly lower in current smoker's before (odds ratio, 0.71; 95% CI, 0.52-0.96) and more so after (odds ratio, 0.47; 95% CI, 0.31-0.70) covariate adjustment. With the propensity score-derived covariate balance, the smoking effect became much less certain (odds ratio, 0.63; 95% CI, 0.36-1.11). Conclusions The current study illustrates the fact that the smoker's paradox is likely to be a result of residual confounding as covariate adjustment may not resolve this if there are many competing prognostic confounders. In this situation, propensity score methods for covariate balancing seem preferable. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT01467973.
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Affiliation(s)
- Suhail A Doi
- College of Medicine QU Health Qatar University Doha Qatar
| | - Nazmul Islam
- College of Medicine QU Health Qatar University Doha Qatar
| | | | - Alawi A Alsheikh-Ali
- Mohammed Bin Rashid University of Medicine and Health Sciences Abu Dhabi United Arab Emirates
| | | | | | | | - Khalid F AlHabib
- Department of Cardiac Sciences King Fahad Cardiac Center King Saud University Riyadh Saudi Arabia
| | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy College of Medicine and Health Sciences Sultan Qaboos University Muscat Oman
| | | | - Wael AlMahmeed
- Sheikh Khalifa Medical City Abu Dhabi United Arab Emirates
| | - Bassam Bulbanat
- Department of Cardiology Sabah Al-Ahmed Cardiac Center ??? Kuwait
| | | | - Haitham Amin
- Department of Cardiology Mohammed Bin Khalifa Cardiac Center Manamah Bahrain
| | - Ahmed Al-Motarreb
- Department of Cardiology Faculty of Medicine Sana'a University Sana'a Yemen
| | - Husam AlFaleh
- Department of Cardiac Sciences King Fahad Cardiac Center King Saud University Riyadh Saudi Arabia
| | | | - Abdulla Shehab
- College of Medicine and Health Sciences UAE University ??? United Arab Emirates
| | - Jassim Al Suwaidi
- Hamad Medical Corporation Doha Qatar.,Weill Cornell Medical College Doha Qatar
| | - Amar M Salam
- College of Medicine QU Health Qatar University Doha Qatar.,Hamad Medical Corporation Doha Qatar.,Weill Cornell Medical College Doha Qatar
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Usefulness of Calculation of Cardiovascular Risk Factors to Predict Outcomes in Patients With Acute Myocardial Infarction. Am J Cardiol 2019; 124:857-863. [PMID: 31327489 DOI: 10.1016/j.amjcard.2019.06.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2019] [Revised: 06/08/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022]
Abstract
Cardiovascular risk factors contribute differently to short-term prognosis of acute myocardial infarction (AMI); hypertension and diabetes increase adverse outcomes, whereas hyperlipidemia, smoking, and obesity seem to paradoxically decrease these in post-MI patients. We aimed to investigate whether a simple calculation of conventional risk factors, PARADOCS (Pressure of ARtery elevAtion, Diabetes, Obesity, Cholesterol, Smoking) score, would improve the ability to predict major adverse cardiac and cerebrovascular events (MACCEs) in post-MI patients. Between November 2011 and December 2015, 13,104 patients with diagnosis of AMI were analyzed in this study from Korean AMI Registry - National Institute of Health database. PARADOCS score was calculated as follows: (number of nonparadoxical risk factors - number of paradoxical risk factors) + 3 where nonparadoxical risk factors are hypertension and diabetes, and paradoxical risk factors are hyperlipidemia, smoking, and obesity. PARADOCS score was significantly greater in patients with 1-year MACCEs compared with those without MACCEs (3.43 ± 1.03 vs 2.88 ± 1.11, p <0.001). In Cox proportional hazards model, PARADOCS score was an independent predictor of 1-year MACCEs (hazards ratio 1.23, 95% confidence interval 1.16 to 1.30; p <0.001) after adjusting for confounding variables. In Kaplan-Meier survival curve, patients with greater PARADOCS score had worse clinical outcome. In conclusion, although it needs more validation, a simple calculation of risk factors, PARADOCS score, could provide useful prognostic information of MI patients to clinicians.
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Song C, Fu R, Dou K, Yang J, Xu H, Gao X, Wang H, Liu S, Fan X, Yang Y. Association between smoking and in-hospital mortality in patients with acute myocardial infarction: results from a prospective, multicentre, observational study in China. BMJ Open 2019; 9:e030252. [PMID: 31471442 PMCID: PMC6720553 DOI: 10.1136/bmjopen-2019-030252] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
INTRODUCTION Smoking is a well-established risk factor for cardiovascular disease. However, the effect of smoking on in-hospital mortality in patients with acute myocardial infarction (AMI) who are managed by contemporary treatment is still unclear. METHODS A cohort study was conducted using data from the China AMI registry between 2013 and 2016. Eligible patients were diagnosed with AMI in accordance with the third universal definition of MI. Propensity score (PS) matching and multivariable logistic regression were used to control for confounders. Subgroup analysis was performed to examine whether the association between smoking and in-hospital mortality varies according to baseline characteristics. RESULTS A total of 37 614 patients were included. Smokers were younger and more frequently men with fewer comorbidities than non-smokers. After PS matching and multivariable log regression analysis were performed, the difference in in-hospital mortality between current smokers versus non-smokers was reduced, but it was still significant (5.1% vs 6.1%, p=0.0045; adjusted OR 0.78, 95% CI 0.69 to 0.88, p<0.001). Among all subgroups, there was a trend towards lower in-hospital mortality in current or ex-smokers compared with non-smokers. CONCLUSIONS Smoking is associated with lower in-hospital mortality in patients with AMI, even after multiple analyses to control for potential confounders. This 'smoker's paradox' cannot be fully explained by confounding alone. TRIAL REGISTRATION NUMBER NCT01874691.
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Affiliation(s)
- Chenxi Song
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Rui Fu
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Kefei Dou
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Jingang Yang
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Haiyan Xu
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Xiaojin Gao
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Hao Wang
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Shuai Liu
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
| | - Xiaoxue Fan
- Medical Research & Biometrics Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases, Beijing, China
| | - Yuejin Yang
- Coronary Heart Disease Center, Fuwai Hospital, Chinese Academy of Medical Sciences, National Center for Cardiovascular Diseases and Peking Union Medical College, Beijing, China
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Liu Z, Xiang Q, Mu G, Xie Q, Zhou S, Wang Z, Chen S, Hu K, Gong Y, Jiang J, Cui Y. Effectiveness and Safety of Platelet ADP -P2Y12 Receptor Inhibitors Influenced by Smoking Status: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2019; 8:e010889. [PMID: 30898054 PMCID: PMC6509729 DOI: 10.1161/jaha.118.010889] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 01/30/2019] [Indexed: 02/07/2023]
Abstract
Background As reports on the influence of cigarette smoking, an important cardiovascular risk factor, on platelet ADP -P2Y12 receptor inhibitors lack consistency, we aimed to assess the effectiveness and safety of platelet ADP -P2Y12 receptor inhibitors influenced by smoking status. Methods and Results PubMed, Web of Science, EMBASE , Clinical Trials, and the Cochrane Library were searched from inception until June 2018. Among the 5076 citations retrieved, 22 studies, including 163 011 patients with or without percutaneous coronary intervention, were included for meta-analysis. Compared with nonsmokers within the first year of follow-up, the reductions of stroke and major adverse cardiovascular event rate were 18% ( P=0.008) and 26% ( P=0.02), respectively. A 20% reduction in stroke ( P=0.02) and a 34% reduction in major adverse cardiovascular event ( P=0.0001) rates were observed in smoking patients without percutaneous coronary intervention. No significant difference was observed in clinical outcome rates among prasugrel, ticagrelor, and clopidogrel in different smoking status. No significant difference was found in myocardial infarction and bleeding event incidence between current smokers and nonsmokers. Conclusions We concluded that current smokers had a lower incidence of major adverse cardiovascular events and stroke events than did nonsmokers, particularly in the early period (1 year) and among patients without percutaneous coronary intervention. However, because of the lack of original adjusted data, smoker's paradox still needs to consider the impact of age and other covariates. Thus, a differential risk-benefit evaluation should be considered, according to different smoking status, patient conditions, and therapy time points.
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Affiliation(s)
- Zhiyan Liu
- Department of PharmacyPeking University First HospitalBeijingChina
- School of Pharmaceutical SciencesPeking University Health Science CenterBeijingChina
| | - Qian Xiang
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Guangyan Mu
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Qiufen Xie
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Shuang Zhou
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Zining Wang
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Shuqing Chen
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Kun Hu
- Department of PharmacyPeking University First HospitalBeijingChina
| | - Yanjun Gong
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Jie Jiang
- Department of CardiologyPeking University First HospitalBeijingChina
| | - Yimin Cui
- Department of PharmacyPeking University First HospitalBeijingChina
- School of Pharmaceutical SciencesPeking University Health Science CenterBeijingChina
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Ek A, Ekblom Ö, Hambraeus K, Cider Å, Kallings LV, Börjesson M. Physical inactivity and smoking after myocardial infarction as predictors for readmission and survival: results from the SWEDEHEART-registry. Clin Res Cardiol 2019; 108:324-332. [PMID: 30167806 PMCID: PMC6394466 DOI: 10.1007/s00392-018-1360-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 08/20/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND Physical activity (PA) and smoking cessation are included in the secondary prevention guidelines after myocardial infarction (MI), but they are still underutilised. This study aims to explore how PA level and smoking status (6-10 weeks post-MI) were associated with 1-year readmission and mortality during full follow-up time, and with the cumulative 5-year mortality. METHODS A population-based cohort of all hospitals providing MI-care in Sweden (SWEDEHEART-registry) in 2004-2014. PA was expressed as the number of exercise sessions of ≥ 30 min in the last 7 days: 0-1 (low), 2-4 (medium) and 5-7 (high) sessions/week. Individuals were categorised as smokers, former smokers or never-smokers. The associations were analysed by unadjusted and adjusted logistic and Cox regressions. RESULTS During follow-up (M = 3.58 years), a total of 1702 deaths occurred among 30 644 individuals (14.1 cases per 1000 person-years). For medium and high PA, the hazard ratios (HRs) for mortality were 0.39 and 0.36, respectively, compared with low PA. For never-smokers, the HR was 0.45 and former smokers 0.56 compared with smokers. Compared with low PA, the odds ratios (ORs) for readmission in medium PA were 0.65 and 0.59 for CVD and non-CVD causes, respectively. For high PA, the corresponding ORs were 0.63 and 0.55. The association remained in adjusted models. There were no associations between smoking status and readmission. CONCLUSIONS The PA level and smoking status are strong predictors of mortality post-MI and the PA level also predicts readmission, highlighting the importance of adherence to the secondary prevention guidelines.
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Affiliation(s)
- Amanda Ek
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, P.O. Box 5626, 11486, Stockholm, Sweden.
- Functional Area Occupational Therapy and Physiotherapy, Allied Health Professionals Function, Karolinska University Hospital, Stockholm, Sweden.
| | - Örjan Ekblom
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, P.O. Box 5626, 11486, Stockholm, Sweden
| | | | - Åsa Cider
- Department of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lena V Kallings
- The Åstrand Laboratory of Work Physiology, The Swedish School of Sport and Health Sciences, P.O. Box 5626, 11486, Stockholm, Sweden
- Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden
| | - Mats Börjesson
- Department of Neuroscience and Physiology, Gothenburg University, Gothenburg, Sweden
- Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Food, Nutrition and Sports Science, Gothenburg University, Gothenburg, Sweden
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Park HW, Kang MG, Kim K, Koh JS, Park JR, Jeong YH, Ahn JH, Jang JY, Kwak CH, Park Y, Jeong MH, Kim YJ, Cho MC, Kim CJ, Hwang JY. Long-term Prognosis and Clinical Characteristics of Patients with Newly Diagnosed Diabetes Mellitus Detected after First Acute Myocardial Infarction: from KAMIR-NIH Registry. Korean Circ J 2018; 48:134-147. [PMID: 29441746 PMCID: PMC5861004 DOI: 10.4070/kcj.2017.0174] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2017] [Revised: 11/06/2017] [Accepted: 12/13/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND AND OBJECTIVES After the first acute myocardial infarction (AMI), a considerable proportion of patients are newly diagnosed with diabetes mellitus (DM). However, in AMI, controversy remains regarding the disparity in prognosis between previously diagnosed DM (known-DM) and newly diagnosed DM (new-DM). METHODS The study included 10,455 patients with AMI (non-DM, 6,236; new-DM, 659; known-DM, 3,560) admitted to one of 15 participating centers in Korea between November 2011 and January 2016 (average follow-up, 523 days). We compared the characteristics and clinical course of patients with known-DM and those with new- or non-DM. RESULTS Compared to patients with known-DM, those with new-DM or non-DM were younger, more likely to be male, and less likely to have hypertension, dyslipidemia, prior stroke, angina, or myocardial infarction. Compared to patients with new-DM or non-DM (reference), those with known-DM had higher risks of major adverse cardiac events (hazard ratio [HR], 1.20; 95% confidence interval [CI], 1.06-1.35; p=0.004), cardiac death (HR, 1.26; 95% CI, 1.01-1.57; p=0.042), and congestive heart failure (HR, 1.58; 95% CI, 1.20-2.08). Unlike known-DM, new-DM did not increase the risk of cardiac events (including death). CONCLUSIONS Known-DM was associated with a significantly higher risk of cardiovascular events after AMI, while new-DM had a similar risk of cardiac events as that noted for non-DM. There were different cardiovascular outcomes according to diabetes status in patients with AMI.
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Affiliation(s)
- Hyun Woong Park
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Min Gyu Kang
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Kyehwan Kim
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jin Sin Koh
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Jeong Rang Park
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea
| | - Young Hoon Jeong
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Jong Hwa Ahn
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Jeong Yoon Jang
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Choong Hwan Kwak
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Yongwhi Park
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea
| | - Myung Ho Jeong
- Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Young Jo Kim
- Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea
| | - Myeong Chan Cho
- Department of Internal Medicine, Chungbuk National University Hospital, Cheongju, Korea
| | - Chong Jin Kim
- Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Jin Yong Hwang
- Department of Internal Medicine, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
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Bucholz EM, Beckman AL, Kiefe CI, Krumholz HM. Smoking status and life expectancy after acute myocardial infarction in the elderly. Heart 2015; 102:133-9. [PMID: 26596792 DOI: 10.1136/heartjnl-2015-308263] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 10/13/2015] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Smokers have lower short-term mortality after acute myocardial infarction (AMI) than non-smokers; however, little is known about the long-term effects of smoking on life expectancy after AMI. This study aimed to quantify the burden of smoking after AMI using life expectancy and years of life lost. METHODS We analysed data from the Cooperative Cardiovascular Project, a medical record study of 158,349 elderly Medicare patients with AMI and over 17 years of follow-up, to evaluate the age-specific association of smoking with life expectancy and years of life lost after AMI. RESULTS Our sample included 23,447 (14.8%) current smokers. Current smokers had lower crude mortality up to 5 years, which was largely explained by their younger age at AMI. After adjustment other patient characteristics, smoking was associated with lower 30-day (HR 0.91, 95% CI 0.87 to 0.94) but higher long-term mortality (17-year HR 1.19, 95% CI 1.17 to 1.20) after AMI. Overall, crude life expectancy estimates were lower for current smokers than non-smokers at all ages, which translated into sizeable numbers of life-years lost attributable to smoking. As age at AMI increased, the magnitude of life-years lost due to smoking decreased. After full risk adjustment, the differences in life expectancy between current smokers and non-smokers persisted at all ages. CONCLUSIONS Current smoking is associated with lower life expectancy and large numbers of life-years lost after AMI. Our findings lend additional support to smoking cessation efforts after AMI.
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Affiliation(s)
- Emily M Bucholz
- Department of Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Adam L Beckman
- Yale School of Medicine and Yale School of Public Health, New Haven, Connecticut, USA
| | - Catarina I Kiefe
- Department of Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, Massachusetts, USA
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut, USA Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, Connecticut, USA Section of Health Policy and Administration, School of Public Health, Yale University School of Medicine, New Haven, Connecticut, USA
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Kim HK, Jeong MH, Lee SH, Sim DS, Hong YJ, Ahn Y, Kim CJ, Cho MC, Kim YJ. The scientific achievements of the decades in Korean Acute Myocardial Infarction Registry. Korean J Intern Med 2014; 29:703-12. [PMID: 25378967 PMCID: PMC4219958 DOI: 10.3904/kjim.2014.29.6.703] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Accepted: 09/08/2014] [Indexed: 11/27/2022] Open
Abstract
The Korea Acute Myocardial Infarction Registry (KAMIR) was the first nationwide registry data collection designed to track outcomes of patients with acute myocardial infarction (AMI). These studies reflect the current therapeutic approaches and management for AMI in Korea. The results of KAMIR could help clinicians to predict the prognosis of their patients and identify better diagnostic and treatment tools to improve the quality of care. The KAMIR score was proposed to be a predictor of the prognosis of AMI patients. Triple antiplatelet therapy, consisting of aspirin, clopidogrel and cilostazol, was effective at preventing major adverse clinical outcomes. Drug-eluting stents were effective and safe in AMI patients with no increased risk of stent thrombosis. Statin therapy was effective in Korean AMI patients, including those with very low levels of low density cholesterol. The present review summarizes the 10-year scientific achievements of KAMIR from admission to outpatient care during long-term clinical follow-up.
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Affiliation(s)
- Hyun Kuk Kim
- The Heart Center, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- The Heart Center, Chonnam National University Hospital, Gwangju, Korea
| | - Seung Hun Lee
- The Heart Center, Chonnam National University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- The Heart Center, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- The Heart Center, Chonnam National University Hospital, Gwangju, Korea
| | - Youngkeun Ahn
- The Heart Center, Chonnam National University Hospital, Gwangju, Korea
| | - Chong Jin Kim
- Cardiovascular Center, Kyung Hee University Hospital at Gangdong, Seoul, Korea
| | - Myeong Chan Cho
- Cardiovascular Center, Chungbuk National University Hospital, Cheongju, Korea
| | - Young Jo Kim
- Cardiovascular Center, Yeungnam University Medical Center, Daegu, Korea
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Suarez-Varela MM, Llopis-González A, González Albert V, López-Izquierdo R, González-Manzano I, Cháves J, Biosca VH, Martin-Escudero JC. Zinc and smoking habits in the setting of hypertension in a Spanish populations. Hypertens Res 2014; 38:149-54. [DOI: 10.1038/hr.2014.150] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2014] [Revised: 07/25/2014] [Accepted: 08/12/2014] [Indexed: 11/09/2022]
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Li YH, Lin GM, Lai CP, Lin CL, Wang JH. The “smoker's paradox” in Asian versus non-Asian patients with percutaneous coronary intervention longer than 6 months follow-up: A collaborative meta-analysis with the ET-CHD registry. Int J Cardiol 2013; 168:4544-8. [DOI: 10.1016/j.ijcard.2013.06.093] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2013] [Accepted: 06/30/2013] [Indexed: 02/05/2023]
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Ali SF, Smith EE, Bhatt DL, Fonarow GC, Schwamm LH. Paradoxical association of smoking with in-hospital mortality among patients admitted with acute ischemic stroke. J Am Heart Assoc 2013; 2:e000171. [PMID: 23782919 PMCID: PMC3698779 DOI: 10.1161/jaha.113.000171] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Compared to those who never smoked, a paradoxical effect of smoking on reducing mortality in patients admitted with myocardial ischemia has been reported. We sought to determine if this effect was present in patients hospitalized with ischemic stroke. METHODS AND RESULTS Using the local Get with the Guidelines-Stroke registry, we analyzed 4305 consecutively admitted ischemic stroke patients (March 2002-December 2011). The sample was divided into smokers versus nonsmokers. The main outcome of interest was the overall inpatient mortality. Compared to nonsmokers, tobacco smokers were younger, more frequently male and presented with fewer stroke risk factors such as hypertension, hyperlipidemia, diabetes, coronary artery disease, and atrial fibrillation. Smokers also had a lower average NIH Stroke Scale (NIHSS) and fewer received tissue plasminogen activator (tPA). Patients in both groups had similar adherence to early antithrombotics, dysphagia screening prior to oral intake, and deep vein thrombosis (DVT) prophylaxis. Smoking was associated with lower all-cause in-hospital mortality (6.6% versus 12.4%; unadjusted OR 0.46; CI [0.34 to 0.63]; P<0.001). In multivariable analysis, adjusted for age, gender, ethnicity, hypertension, diabetes mellitus, hyperlipidemia, CAD, atrial fibrillation, NIHSS, and tPA, smoking remained independently associated with lower mortality (adjusted OR 0.64; CI [0.42 to 0.96]; P=0.03). CONCLUSIONS Similar to myocardial ischemia, smoking was independently associated with lower inpatient mortality in acute ischemic stroke. This effect may be due to tobacco-induced changes in cerebrovascular vasoreactivity, or may be due in part to residual confounding. Larger, multicenter studies are needed to confirm the finding and the effect on 30-day and 1-year mortality.
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Affiliation(s)
- Syed F Ali
- Department of Neurology, Massachusetts General Hospital/Harvard Medical School, Boston, MA 02114, USA
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