Characteristics of Coronary Artery Lesions in Smokers With Coronary Heart Disease and Prognostic Evaluation After Percutaneous Coronary Intervention
10.3969/j.issn.1000-3614.2018.11.004
- VernacularTitle:吸烟的冠心病患者冠状动脉病变特点及经皮冠状动脉介入治疗后长期预后评价
- Author:
Juan WANG
1
;
Hao-Bo XU
;
Shu-Bin QIAO
;
Chang-Dong GUAN
;
Feng-Huan HU
;
Wei-Xian YANG
;
Jian-Song YUAN
;
Chao GUO
;
Xin DUAN
;
Run-Lin GAO
;
Bo XU
Author Information
1. 100037,中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 冠心病中心
- Keywords:
Smoking;
Coronary atherosclerotic heart disease;
Percutaneous coronary intervention
- From:
Chinese Circulation Journal
2018;33(11):1053-1058
- CountryChina
- Language:Chinese
-
Abstract:
Objectives: To investigate the characteristics of coronary lesions and evaluate the prognosis post-percutaneous coronary intervention(PCI)in smokers with coronary heart disease. Methods: The data were derived from PANDA III, which was a perspective, multi-center, "all-comer", randomized controlled trial. Between Dec. 2013 and Aug. 2014, 2 348 patients from 46 centers were enrolled. Mean age was (61.2 ±10.6) years old, 1 658 patients (70.6%) were male. All the patients underwent PCI and biodegradable polymer drug eluting stents were implanted as indicated. Patients were divided into non-smoking group, quitter group and smoking-group based on the basis of smoking status at baseline. Primary endpoint was major adverse cardiac events (MACE), including all-cause mortality, myocardial infarction and repeated revascularization. Secondary endpoint were stent thrombosis and target lesion failure (TLF), including cardiac death, target vessel myocardial infarction and ischemia driven target lesion revascularization. Results: Smokers and quitters were more often males. Compared with non-smoking group and quitter group, patients in smoking group were significantly younger (P<0.0001), proportion of hypertension (P=0.0002), diabetes mellitus (P=0.0052) and previous PCI history (P<0.0001) was significantly lower. The incidence of acute myocardial infarction in the smoking group was as high as 41.3% (363/879), which was significantly higher than that of the quitter group and non-smoking group (P<0.0001). A total of 1 130 (96.7%), 286 (95.3%) and 846 (96.2%) patients in the non-smoking group, quitter group and smoking-group completed the 2-year follow-up, respectively. The results of 2-years follow-up showed that MACE rate of non-smoking group, quitter group and smoking-group was 11.23%, 13.64% and 12.21%(P=0.54), respectively. Multivariable cox regression analysis indicated that smoking status was not an independent predictor for all-cause mortality and TLF.
