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目的探讨吸烟对于行冠状动脉介入的患者住院期间及长期预后的影响。方法连续纳入了自2013年1月份至12月份于中国医学科学院阜外医院行介入治疗的急性冠脉综合症患者6431例,根据吸烟状态分为非吸烟组和吸烟组,观察吸烟对行冠状动脉介入治疗患者短期及长期预后的影响。结果吸烟组患者年龄更小、男性为主且平均住院时间更短,住院期间全因死亡及心源性死亡吸烟组明显低于非吸烟组(0.1%vs 0.4%,P=0.015;0.1%vs 0.4%,P=0.048);而在出血、脑卒中、支架内血栓以及新发心肌梗死事件发生率方面两组无显著差异。2年随访结果显示:吸烟组的脑卒中和心源性死亡发生率明显低于非吸烟组(1.2%vs 1.8%,P=0.036;0.6%vs 1.1%,P=0.026),而全因死亡两组间无显著差异。多因素分析显示吸烟并非院内死亡率以及2年随访时脑卒中、心源性死亡的独立预测因子。结论对于行冠状动脉介入治疗的患者,吸烟患者的短期及长期预后好于非吸烟者,但吸烟并非独立预测因子。
Objective To investigate the effect of smoking on hospitalization and long-term prognosis of patients undergoing coronary intervention. Methods A total of 6431 patients with acute coronary syndrome who underwent interventional treatment at Fuwai Hospital of Chinese Academy of Medical Sciences from January 2013 to December 2013 were enrolled. According to smoking status, they were divided into non-smoking group and smoking group. Interventional treatment of patients with short-term and long-term prognosis. Results The smokers were younger, men were predominant and had shorter average hospital stays. All-cause and cardiac death smokers during hospital stay were significantly lower than those in non-smokers (0.1% vs 0.4%, P = 0.015; 0.1% vs 0.4%, P = 0.048). There was no significant difference between the two groups in the incidence of hemorrhage, stroke, stent thrombosis and new myocardial infarction. The 2-year follow-up results showed that the incidence of stroke and cardiac death was significantly lower in smokers than in nonsmokers (1.2% vs 1.8%, P = 0.036; 0.6% vs 1.1%, P = 0.026) No significant difference between the two groups. Multivariate analysis showed that smoking was not an in-hospital mortality rate and an independent predictor of stroke and cardiac death at 2-year follow-up. Conclusions For patients undergoing coronary intervention, the short-term and long-term prognosis of smokers is better than that of nonsmokers, but smoking is not an independent predictor.