CAJ | 학술논문

目的研究冠心病患者在经皮冠状动脉介入治疗(PCI)后吸烟状态对临床预后的影响.方法调查592例冠心病患者PCI术前及术后的吸烟状态,根据PCI后吸烟状态将患者分为3组:不吸烟组(n=272)、戒烟组(n=215)及目前吸烟组(n=105),详细记录随访时主要不良心脏事件的发生情况.结果平均随访19.0个月.术前吸烟率为54.1%,随访时为17.7%.与不吸烟组比较,目前吸烟组患者较年轻(P<0.01),男性较多(P<0.01),高血压病(P<0.05)、糖尿病(P<0.05)较少.病变冠状动脉数(P<0.05)、置人的支架数(P<0.01)也较少,参考冠状动脉的直径较大(P<0.01).与不吸烟组比较,目前吸烟组(0.37%比4.76%,P<0.01)及戒烟组(0.37%比1.40%,P<0.05)的非致死性心肌梗死发生率较高.在校正组间不匹配因素后,logistic多元逐步回归显示随访期间吸烟是PCI术后发生非致死性心肌梗死的危险因素(回归系数为1.28,P<0.01).结论 PCI术后吸烟是术后发生非致死性心肌梗死的危险因素之一.
목적 연구관심병환자재경피관상동맥개입치료(PCI)후흡연상태대림상예후적영향.방법 조사592례관심병환자PCI술전급술후적흡연상태,근거PCI후흡연상태장환자분위3조:불흡연조(n=272)、계연조(n=215)급목전흡연조(n=105),상세기록수방시주요불양심장사건적발생정황.결과 평균수방19.0개월.술전흡연솔위54.1%,수방시위17.7%.여불흡연조비교,목전흡연조환자교년경(P<0.01),남성교다(P<0.01),고혈압병(P<0.05)、당뇨병(P<0.05)교소.병변관상동맥수(P<0.05)、치인적지가수(P<0.01)야교소,삼고관상동맥적직경교대(P<0.01).여불흡연조비교,목전흡연조(0.37%비4.76%,P<0.01)급계연조(0.37%비1.40%,P<0.05)적비치사성심기경사발생솔교고.재교정조간불필배인소후,logistic다원축보회귀현시수방기간흡연시PCI술후발생비치사성심기경사적위험인소(회귀계수위1.28,P<0.01).결론 PCI술후흡연시술후발생비치사성심기경사적위험인소지일.
Objective To assess the association between smoking status at follow-up and clinical outcomes in patients undergoing successful percutancous coronary intervention (PCI). Methods The smoking status at follow-up was investigated in 592 patients undergoing successful PCI between Jan. 2003 and Nov. 2006. The patients were divided into three groups on the basis of their smoking status at follow-up: non-smokers (n=272), quitters (n=215) and current smokers (n=105). Major adverse cardiac events were recorded. Results The average follow-up time was 19. 0 months. At follow-up, current smokers were significantly younger (P < 0.01), more likely to be male (P < 0.01) than non-smokers and had more favorable clinical and angiographic characteristics: lower prevalence of hypertension (P < 0.05) and diabetes (P < 0.05), fewer diseased vessels (P < 0.05) and fewer implanted coronary stents (P < 0.01), larger target vessel diameter (P < 0.01). However, the incidence of non-fatal myocardial infarction (MI) in quitters (1.40%) was significantly higher than in nonsmokers (0.37%, P < 0.05), the incidence of non-fatal MI in current smokers (4.76%) was significantly higher than quitters (1.40%, P < 0.05) and nonsmokers (0.37%, P<0.01). After adjustments for age, gender, hypertension, diabetes, dyslipidacmia, target vessel diameter, the number of diseased vessels, the kind and number of implanted stents, and the follow-up time, multi-variables logistic regression analysis showed that current smoking was a independent predictive factor for non-fatal MI (β=1.28, wald X2=6.91, P < 0.01) . Conclusions Smokers, especially current smokers, were at increased risk for non-fatal MI post successful PCI. Therefore, all patients underwent PCI should be encouraged to stop smoking.