Effects of Smoking on Ischemic Stroke, Intracranial Hemorrhage, and Coronary Artery Events in Japanese Patients With Non-Valvular Atrial Fibrillation
| Autor: | Yuji Oikawa, Yuko Kato, Shunsuke Matsuno, Hiroto Kano, Hitoshi Sawada, Tadanori Aizawa, Junji Yajima, Tokuhisa Uejima, Takashi Kunihara, Takeshi Yamashita, Kazuyuki Nagashima, Takayuki Otsuka, Koichi Sagara, Hajime Kirigaya, Shinya Suzuki, Hideaki Takai, Hiroaki Semba |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Acute coronary syndrome business.industry Proportional hazards model medicine.medical_treatment Percutaneous coronary intervention Atrial fibrillation General Medicine 030204 cardiovascular system & hematology Lower risk medicine.disease 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology Conventional PCI medicine Cardiology Cardiology and Cardiovascular Medicine business Stroke 030217 neurology & neurosurgery |
| Zdroj: | International Heart Journal. 58:506-515 |
| ISSN: | 1349-3299 1349-2365 |
| DOI: | 10.1536/ihj.16-228 |
| Popis: | The effects of smoking on the prognosis of non-valvular atrial fibrillation (NVAF) patients are unclear.The Shinken Database 2004-11 (n = 17,517) includes all new patients visiting the Cardiovascular Institute between June 2004 and March 2012. Among these cases, 2,102 NVAF patients were identified. The effects of smoking on ischemic stroke (IS), intracranial hemorrhage (ICH), and coronary artery events including percutaneous coronary intervention (PCI) and acute coronary syndrome (ACS) were analyzed. Smokers were younger and had lower risk profiles compared with non-smokers. A similar tendency was observed between current and former smokers. In contrast, patients with high tobacco consumption were older and had higher risk profiles, including uncontrolled hypertension, compared with those with low tobacco consumption. In 8,159 patient-years, IS, ICH, PCI, and ACS occurred at rates of 7.7, 2.7, 12.4, and 3.0 per 1000 patient-years. In multivariate Cox regression analysis, smoking was not significantly associated with any adverse event. However, different effects of smoking were observed when stratified by age. In patients ≥ 65 years old, current smokers were independently associated with PCI. Moreover, current smokers and smokers with a total tobacco amount ≥ 800 were marginally and independently associated with IS. In patients < 65 years, current smokers were independently associated with ICH.Age appears to be one of the contributors to differentiation of the effects of smoking on cardiovascular events in our NVAF patients. In elderly patients who still smoke, smoking was associated with the promotion of atherosclerosis or thromboembolism, whereas in young patients it was associated with bleeding. |
| Databáze: | OpenAIRE |
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