吸烟者与非吸烟者急性冠脉综合征的临床特征、危险因素、血管造影特征及短期死亡率的研究

B. Reddy, Hemasundar Korrapati, Supraja Chegireddy
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摘要

背景:长期以来,吸烟与冠心病的发生和发展呈正相关。然而,评估心脏病患者吸烟习惯的纵向队列研究以及决定此类行为的社会人口因素的作用很少,并且主要集中在初级保健实践中。急性冠状动脉综合征在年轻人中的患病率正在逐渐增加。以往的研究主要集中在分析吸烟者与非吸烟者急性冠脉综合征患者的危险因素和一定程度的冠状动脉造影特征。本研究的目的是研究吸烟者与非吸烟者的急性冠状动脉综合征,并分析其基线特征。对象与方法:本研究是在Katuri医学院心内科和Guntur医院进行的前瞻性研究。结果:在本研究中,吸烟者发生急性冠脉综合征的时间比不吸烟者早7年(p<0.05);吸烟者多为男性(p<0.001);吸烟者患糖尿病的比例比不吸烟者低(p<0.001);吸烟者患肥胖症的比例比不吸烟者高(p<0.001)。与不吸烟者相比,吸烟者出现更多的急性梗死和更少的不稳定型心绞痛(P<0.001)。结论:在本研究中,吸烟者和非吸烟者STEMI和NSTEMI/UA患者的冠状动脉危险因素谱存在显著差异。需要更大规模的研究来确定吸烟者急性冠状动脉综合征的表现与血管造影之间的具体联系。
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A Study on Clinical Profile, Risk Factors, Angiographic Profile and Short-Term Mortality of Acute Coronary Syndrome in Smokers vs Non Smokers
Background: Smoking has long been positively associated with the development and progression of coronary heart disease. However, lon- gitudinal cohort studies evaluating smoking habits among cardiac patients as well as the role of socio-demographic factors determining such behaviours are scarce and have been focused on primary care practice. Prevalence of acute coronary syndrome in young individuals is increasing progressively. Previous studies have focused on the analysis of risk factors and to some extent coronary angiographic profile in smokers         vs non-smokers patients with acute coronary syndrome. The aim of the study is to study the acute coronary syndrome in smokers versus non-smokers and to analyse with respect to baseline characteristics. Subjects and Methods: It was a prospective study conducted at Department of Cardiology, Katuri Medical College & Hospital Guntur. Results: In the present study, Acute coronary syndrome occurred seven years earlier in smokers compared with non-smokers (p<0.05) Smokers were frequently male subjects compared with non-smokers (p<0.001) Smokers had a lower prevalence of Diabetes compared with non-smokers (p<0.001) Smokers had a higher prevalence of Obesity compared with non-smokers (p<0.001). Smokers presented with more acute infarctions and less Unstable angina compared with non-smokers (P<0.001). Conclusion: In  the present study, significant differences were observed in coronary risk factor profile between smokers and non-smokers patients with STEMI and NSTEMI/UA. Larger studies will be required to establish specific associations between presentation of acute coronary syndromes and angiographic profiles in smokers.
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