1. Impact of persistent smoking on long-term outcomes in patients with nonvalvular atrial fibrillation.
- Author
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Nakagawa K, Hirai T, Ohara K, Fukuda N, Numa S, Taguchi Y, Dougu N, Takashima S, Nozawa T, Tanaka K, and Inoue H
- Subjects
- Aged, Aged, 80 and over, Female, Follow-Up Studies, Heart Failure epidemiology, Heart Failure mortality, Humans, Incidence, Intracranial Hemorrhages mortality, Kaplan-Meier Estimate, Longitudinal Studies, Male, Middle Aged, Myocardial Infarction epidemiology, Myocardial Infarction mortality, Prognosis, Retrospective Studies, Risk Factors, Stroke epidemiology, Stroke mortality, Atrial Fibrillation complications, Atrial Fibrillation diagnosis, Intracranial Hemorrhages epidemiology, Smoking adverse effects
- Abstract
Background: Although smoking is a risk factor for cardiovascular diseases, little is known about the impact of smoking on long-term outcomes in patients with atrial fibrillation (AF)., Methods: In 426 consecutive patients with nonvalvular AF (mean age, 66 years; 307 men; mean follow-up, 5.8±3.2 years), clinical variables including smoking status, CHADS2, and CHA2DS2-VASc score, incidences of cardiovascular events (stroke, myocardial infarction, or admission for heart failure), bleeding, and mortality were determined., Results: Incidences of intracranial bleeding (0.7% vs 0.1%/year, p<0.01), all-cause mortality (4.9% vs 2.6%/year, p<0.01), and death from stroke (0.8% vs 0.2%/year, p<0.05) were higher in patients with history of smoking than in those without it. Incidence of intracranial bleeding was significantly higher in persistent smokers than in non-persistent smokers (1.2% vs 0.2%/year, p<0.01). History of smoking predicted all-cause mortality [hazard ratio (HR), 2.7; 95% confidence interval (CI), 1.7-4.5; p<0.01] and death from stroke (HR 4.7; 95% CI 1.0-22.3; p<0.05) independent of age, antithrombotic treatment, CHADS2, and CHA2DS2-VASc score. Persistent smoking predicted intracranial bleeding (HR 4.4; 95% CI 1.1-17.6; p<0.05) independent of age and antithrombotic treatment., Conclusions: Smoking status, independent of age, antithrombotic treatment, and clinical risk factors, predicted long-term adverse outcomes including bleeding events in patients with nonvalvular AF. There might be an obvious impact of persistent smoking on intracranial bleeding., (Copyright © 2014. Published by Elsevier Ltd.)
- Published
- 2015
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