The German CPU registry: Comparison of smokers and nonsmokers.
Herz
; 45(3): 293-298, 2020 May.
Article
em En
| MEDLINE
| ID: mdl-30054712
ABSTRACT
BACKGROUND:
Chest pain is a major reason for admission to an internal emergency department, and smoking is a well-known risk factor for coronary artery disease (CAD) and acute coronary syndrome (ACS). The aim of this analysis is to illustrate the differences between smokers and nonsmokers presenting to German chest pain units (CPU) in regard to patient characteristics, CAD manifestation, treatment strategy, and prognosis.METHODS:
From December 2008 to March 2014, 13,902 patients who had a complete 3month follow-up were enrolled in the German CPU registry. The analysis comprised 5796 patients with ACS and documented smoking status.RESULTS:
Of all the patients in the CPU registry, 35.2% were smokers. Compared with nonsmokers, they were 13.5 years younger (58.2 vs. 71.7 years, pâ¯< 0.001), predominantly men (77.1% vs. 65.2%, pâ¯< 0.001), and were more frequently diagnosed with single-vessel disease (32.1% vs. 25.2%) as well as ST-elevation myocardial infarction (STEMI; 23.8% vs. 15.5%, pâ¯< 0.001). Although the Global Registry of Acute Coronary Events (GRACE) Risk Score for hospital mortality was lower in the group of smokers (106.1 vs. 123.3, pâ¯< 0.001), we did not observe any differences in CPU death (0.4% vs. 0.4%, pâ¯= 0.69) and CPU major adverse cardiac event (MACE) rates (3.8% vs 2.9%, pâ¯= 0.073) between the groups. In the 3month follow-up, we documented higher mortality rates in the nonsmoker group (1.9% vs. 2.9%, pâ¯= 0.035) in correlation with the GRACE Risk Score (80.3 vs. 105.2, pâ¯< 0.001). MACE rates were similar during the follow-up (3.1% vs. 4.1%, pâ¯= 0.065).CONCLUSION:
Observations from the German CPU registry demonstrate that smoking is a strong predictor of acute CAD manifestation early in life, especially STEMI. In spite of a lower GRACE Risk Score and fewer comorbidities, smokers had a rate of hospital mortality similar to the older group of nonsmokers.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Dor no Peito
/
Sistema de Registros
/
Síndrome Coronariana Aguda
/
Não Fumantes
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
País/Região como assunto:
Europa
Idioma:
En
Revista:
Herz
Ano de publicação:
2020
Tipo de documento:
Article
País de afiliação:
Alemanha