Effects of Smoking on Major Adverse Cardiovascular Events in Patients With Coronary Artery Spasm: A Systematic Review and Meta-Analysis

IF 2.2 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Heart, Lung and Circulation Pub Date : 2024-09-01 DOI:10.1016/j.hlc.2024.02.015

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Abstract

Background

Smoking is an established independent risk factor for coronary artery spasm (CAS), but its effects on major adverse cardiovascular events (MACE) in patients with CAS have not been systematically assessed.

Methods

This systematic review and meta-analysis of studies published from January 2000 to July 2023 was conducted to examine the relationship between smoking and MACE in patients with CAS. Data on MACE were obtained from both smoking and non-smoking CAS patient groups. The effects of smoking on MACE in patients with CAS were assessed through meta-analysis, utilising Stata 17.0 software for all statistical analyses.

Results

Nine studies, encompassing 9,376 patients, from Japan (5 studies), Korea (4 studies) and Spain (1 study) were included in the final analysis. Meta-analysis revealed that smoking significantly impacted MACE in patients with CAS (RR 1.965; 95% CI 1.348–2.865), a finding further validated by sensitivity analyses. Subgroup analyses identified a stronger correlation between smoking and increased MACE endpoints in Japanese patients and in those with >3 years of follow-up.

Conclusions

This meta-analysis strongly indicates that smoking escalates the risk of MACE in patients with CAS, with a more pronounced association observed in Japanese patients and those with extended follow-up periods.

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吸烟对冠状动脉痉挛患者主要不良心血管事件的影响：系统回顾与元分析》。

背景：吸烟是冠状动脉痉挛（CAS）的一个公认的独立危险因素，但吸烟对CAS患者主要不良心血管事件（MACE）的影响尚未得到系统评估：本研究对 2000 年 1 月至 2023 年 7 月期间发表的研究进行了系统回顾和荟萃分析，以探讨吸烟与 CAS 患者 MACE 之间的关系。MACE数据来自吸烟和不吸烟的CAS患者群体。所有统计分析均采用Stata 17.0软件，通过荟萃分析评估吸烟对CAS患者MACE的影响：最终分析纳入了来自日本（5 项研究）、韩国（4 项研究）和西班牙（1 项研究）的 9 项研究，共计 9,376 名患者。Meta 分析显示，吸烟对 CAS 患者的 MACE 有显著影响（RR 1.965；95% CI 1.348-2.865），敏感性分析进一步验证了这一结论。亚组分析发现，在日本患者和随访时间超过3年的患者中，吸烟与MACE终点增加之间的相关性更强：这项荟萃分析有力地表明，吸烟会增加CAS患者的MACE风险，在日本患者和随访时间较长的患者中观察到更明显的相关性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Heart, Lung and Circulation CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

4.50

自引率

3.80%

发文量

912

审稿时长

11.9 weeks

期刊介绍： Heart, Lung and Circulation publishes articles integrating clinical and research activities in the fields of basic cardiovascular science, clinical cardiology and cardiac surgery, with a focus on emerging issues in cardiovascular disease. The journal promotes multidisciplinary dialogue between cardiologists, cardiothoracic surgeons, cardio-pulmonary physicians and cardiovascular scientists.